Organization
HEALTHQWEST FRONTIERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBYN TANIS (EXECUTIVE DIRECTOR OF CONTRACT MGMT)
(856) 533-8762
Entity
Organization
Contact information
Practice address
890 NORTHWOODS PLAZA, MACON, GA 31204-1441
(478) 330-7164
Mailing address
1317 ROUTE 73 STE 200, MOUNT LAUREL, NJ 08054-2202
(856) 439-6111
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
NTP001074
GA
261QR0800X
Recovery Care Clinic/Center
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Other
Enumeration date
01/03/2014
Last updated
03/04/2024
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