Organization
INNER VOYAGE WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFF BAUCOM (CEO)
(404) 713-4280
Entity
Organization
Contact information
Practice address
2230 TOWNE LAKE PKWY, BLDG 900 STE 250, WOODSTOCK, GA 30189-5584
(404) 713-4280
Mailing address
2230 TOWNE LAKE PKWY STE 250, WOODSTOCK, GA 30189-5584
(404) 713-4280
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
—
—
2472E0500X
EEG Technician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
02/09/2023
Last updated
09/08/2025
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