Organization
SOUTHEAST DETOX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN WELCH (PARTNER)
(770) 217-7832
Entity
Organization
Contact information
Practice address
4300 MARTHA BERRY HWY NE, ROME, GA 30165-8642
(770) 217-7832
Mailing address
2328 10TH AVE N STE 202, LAKE WORTH, FL 33461-6612
(561) 990-9951
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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