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Organization

BREAKTHROUGH ADDICTION RECOVERY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SONNY CALHOUN (MANAGING PARTNER)
(770) 352-4374
Entity
Organization

Contact information

Practice address
8000 MILLER CT E, NORCROSS, GA 30071-1456
(770) 734-8091
(770) 734-8094
Mailing address
8000 MILLER CT E, NORCROSS, GA 30071-1456
(770) 734-8091
(770) 734-8094

Taxonomy

Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
00205360
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00205360
BUSINESS LICENSE NUMBER
GA
Enumeration date
04/20/2007
Last updated
10/25/2007
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