Organization
ADDICTION RECOVERY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYDE J WASHBURN CAC II (OWNER/COUNSELOR)
(706) 594-4735
Entity
Organization
Contact information
Practice address
100 SMITH ST, STE #1, LAGRANGE, GA 30240-2780
(706) 594-4735
(706) 243-4701
Mailing address
100 SMITH ST, STE #1, LAGRANGE, GA 30240-2780
(706) 594-4735
(706) 243-4701
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
012692
GA
101YM0800X
Mental Health Counselor
LPC002077
GA
101YM0800X
Mental Health Counselor
LPC003428
GA
Other
Enumeration date
04/30/2014
Last updated
04/30/2014
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