Organization
WILLOW CREEK SUBSTANCE ABUSE PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY W HOOKS LPC (DIRECTOR)
(706) 636-2692
Entity
Organization
Contact information
Practice address
10 KIKER ST, ELLIJAY, GA 30540-3700
(706) 636-2692
(760) 636-2694
Mailing address
10 KIKER ST, ELLIJAY, GA 30540-3700
(706) 636-2692
(760) 636-2694
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
LPC003706
GA
Other
Enumeration date
03/25/2009
Last updated
03/25/2009
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