Organization
KINGSTON WELLNESS RETREAT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE CRAIG (VP FACILITY OPERATIONS)
(561) 797-3264
Entity
Organization
Contact information
Practice address
45 E HOWARD ST, KINGSTON, GA 30145-3003
(561) 797-3264
Mailing address
100 GOVERNORS TRCE STE 101, PEACHTREE CITY, GA 30269-4853
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
323P00000X
Psychiatric Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
02/21/2025
Last updated
11/26/2025
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