Organization
STILLWATER SOUTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NICHOLAS MATHEWS (CEO)
(503) 791-3205
Entity
Organization
Contact information
Practice address
553 STOVER RD, CANTON, GA 30115-4508
(503) 791-3205
Mailing address
4575 WEBB BRIDGE RD, ALPHARETTA, GA 30005-4256
(503) 791-3205
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/03/2022
Last updated
02/03/2022
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