Organization
AGAPE RECOVERY HOUSE LLC
Active
Organization
AGAPE RECOVERY HOUSE LLC
Active
Other names
Inner Voyage Recovery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF BENNETT BAUCOM CACI (OWNER/OPERATOR)
(404) 713-4280
Entity
Organization
Contact information
Practice address
2230 TOWNE LAKE PKWY STE 200, WOODSTOCK, GA 30189-5540
(404) 713-4280
Mailing address
2230 TOWNE LAKE PKWY, BLDG 900 STE 200, WOODSTOCK, GA 30189-5546
(404) 713-4280
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
07/02/2021
Last updated
08/26/2024
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