GOOD LANDING RECOVERY CORPORATION NPI 1992209811

NPI Information

NPI: 1992209811
Provider Name: GOOD LANDING RECOVERY, CORPORATION
Classification: Counselor - 101YA0400X
Entity Type: Organization

Specialization: Addiction (Substance Use Disorder)

CLIA Number: 11D2148897

Address:
256 MCMILLAN RD STE B
DACULA, GA
ZIP 30019
Phone: (770) 570-7422
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GOOD LANDING RECOVERY, CORPORATION is an addiction (substance use disorder) counselor in Dacula, GA. GOOD LANDING RECOVERY, CORPORATION NPI is 1992209811. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

256 MCMILLAN RD STE B
DACULA, GA
ZIP 30019-337
Phone: (770) 570-7422

The provider's authorized official is Robert Pearson Lewis .
The authorized official title is Ceo/owner and has the following contact phone number (770) 570-7422.

The CLIA number assigned to this NPI record is 11D2148897 - other - substacne abuse clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/23/2018 and was last updated on 3/23/2018.

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	101YA0400X	Counselor	Addiction (Substance Use Disorder)	LPC005933	GEORGIA	Yes
2	324500000X	Substance Abuse Rehabilitation Facility			GEORGIA	No

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

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