Organization
POTTERS HANDS INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOBOLAJI OYEBANJO (CEO)
(770) 459-8799
Entity
Organization
Contact information
Practice address
307 OLD STONE RD, VILLA RICA, GA 30180-1214
(770) 459-8799
(770) 459-8919
Mailing address
307 OLD STONE RD, VILLA RICA, GA 30180-1214
(770) 459-8799
(770) 459-8919
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
DRUG000750
GA
Other
Enumeration date
06/09/2010
Last updated
06/09/2010
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