Organization
HEAVENS COVE
Active
Organization
HEAVENS COVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREA MOORE (CEO)
(678) 499-4429
Entity
Organization
Contact information
Practice address
2049 PERKERSON RD SW, ATLANTA, GA 30310-5052
(678) 499-4429
Mailing address
13295 PROVIDENCE LAKE DR, ALPHARETTA, GA 30004-7507
(678) 499-4429
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
060-682
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291203416A
—
GA
05
—
291203416B
—
GA
Enumeration date
11/30/2008
Last updated
11/30/2008
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