Organization
HEALTHQWEST 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
607 RUSSELL PKWY STE A, WARNER ROBINS, GA 31088-7690
(478) 225-9860
Mailing address
1317 ROUTE 73 STE 200, MOUNT LAUREL, NJ 08054-2202
(856) 439-6111
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
PHOP000044
GA
261QM2800X
Methadone Clinic
Primary
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
Other
Enumeration date
12/15/2010
Last updated
09/02/2020
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