STILLWATER SOUTH LLC NPI 1891449351

NPI Information

NPI: 1891449351
Provider Name: STILLWATER SOUTH LLC
Classification: Substance Abuse Rehabilitation Facility - 324500000X
Entity Type: Organization
Address:
553 STOVER RD
CANTON, GA
ZIP 30115
Phone: (503) 791-3205
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STILLWATER SOUTH LLC is a substance abuse rehabilitation facility in Canton, GA. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. STILLWATER SOUTH LLC NPI is 1891449351. The provider is registered as an organization entity type.

The provider's business location address is:

553 STOVER RD
CANTON, GA
ZIP 30115-508
Phone: (503) 791-3205

The provider's authorized official is Nicholas Mathews .
The authorized official title is Ceo and has the following contact phone number (503) 791-3205.

The enumeration date for this NPI number is 2/3/2022 and was last updated on 2/3/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	324500000X	Substance Abuse Rehabilitation Facility				Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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