Organization
BISON RIDGE RECOVERY LODGE, LLC
Active
Other names
Bison Ridge Recovery Lodge
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLIE CAMPBELL (PRESIDENT)
(904) 302-3202
Entity
Organization
Contact information
Practice address
224 LAVENDER TRL NW, ROME, GA 30165-7896
(770) 296-4555
Mailing address
4451 ALABAMA HWY NW, ROME, GA 30165-9200
(770) 296-4555
(706) 739-7276
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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