Organization
BISON RIDGE RECOVERY LODGE, LLC
Active
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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