Provider Demographics
NPI:1194116855
Name:ASSISTED RECOVERY CENTER OF GEORGIA INCORPORATED
Entity type:Organization
Organization Name:ASSISTED RECOVERY CENTER OF GEORGIA INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-352-2425
Mailing Address - Street 1:308 COMMERCIAL DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3684
Mailing Address - Country:US
Mailing Address - Phone:312-352-2425
Mailing Address - Fax:312-352-4436
Practice Address - Street 1:308 COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3684
Practice Address - Country:US
Practice Address - Phone:312-352-2425
Practice Address - Fax:312-352-4436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA025-470-D251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health