Organization
PERSONAL RECOVERY NETWORK LLC
Active
Parent organization
PERSONAL RECOVERY NETWORK LLC
Other names
Georgia Behavioral Health Professionals
Organization subpart
Yes
Provider details
NPI number
Legal business name
PERSONAL RECOVERY NETWORK LLC
Authorized official
ASHLEY TAGTACHIAN (ADMINISTRATOR)
(770) 548-2589
Entity
Organization
Contact information
Practice address
4015 S COBB DR SE, SMYRNA, GA 30080-6303
(770) 431-2354
Mailing address
250 CORPORATE CENTER CT, STOCKBRIDGE, GA 30281-6388
(770) 389-8100
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
02/24/2016
Last updated
08/09/2017
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