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
MRS. ASHLEY NICHOLS TAGTACHIAN (ADMINISTRATOR)
(770) 548-2589
Entity
Organization
Contact information
Practice address
6385 MCGINNIS FERRY RD, SUITE 202, JOHNS CREEK, GA 30005-3621
(470) 482-6508
(770) 476-9750
Mailing address
10090 MEDLOCK BRIDGE, STE 110, JOHNS CREEK, GA 30097
(470) 482-6508
(770) 476-9750
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
02/17/2016
Last updated
08/09/2017
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