Organization
ACWORTH OUTPATIENT DETOX, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN DENKER (MEMBER)
(229) 560-8634
Entity
Organization
Contact information
Practice address
6060 LAKE ACWORTH DR NW STE H, ACWORTH, GA 30101-7358
(229) 560-8634
Mailing address
6060 LAKE ACWORTH DR NW STE H, ACWORTH, GA 30101-7358
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
261QR0800X
Recovery Care Clinic/Center
—
—
Other
Enumeration date
07/15/2021
Last updated
06/24/2022
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