Organization
KENNESAW TRAUMA AND ADDICTION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENEE LYNN ARBOGAST LPC (PRESIDENT)
(828) 333-8595
Entity
Organization
Contact information
Practice address
3745 CHEROKEE ST NW STE 101, KENNESAW, GA 30144-6790
(828) 333-8595
Mailing address
3745 CHEROKEE ST NW STE 101, KENNESAW, GA 30144-6790
(828) 333-8595
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
09/15/2021
Last updated
02/06/2025
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