Organization
ARISE RECOVERY RESIDENCES
Active
Other names
Arise Recovery & Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY JENKINS B.S, CAC II, NCAC II (CEO)
(678) 216-6706
Entity
Organization
Contact information
Practice address
116 PEACHTREE CT STE A, PEACHTREE CITY, GA 30269-4800
(770) 719-1746
(770) 719-2368
Mailing address
116 PEACHTREE CT STE A, PEACHTREE CITY, GA 30269-4800
(678) 725-2631
(770) 719-2368
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DRUG012980
DATEP LICENSE
GA
Enumeration date
10/14/2021
Last updated
02/20/2022
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