Organization
WILLOW CREEK ADOLESCENT SUBSTANCE ABUSE PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY W HOOKS (CEO AND DIRECTOR)
(706) 636-2692
Entity
Organization
Contact information
Practice address
10 KIKER ST, ELLIJAY, GA 30540-3700
(706) 636-2692
(706) 636-2694
Mailing address
10 KIKER ST, ELLIJAY, GA 30540-3700
(706) 636-2692
(706) 636-2694
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LPC003706
GA
Other
Enumeration date
08/19/2008
Last updated
08/19/2008
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