Edge Treatment LLC
Substance Abuse Rehabilitation Facility in Roswell, GA. Organization (NPI-2).
NPI number1265216683
StatusActive
Last updated in NPPESOct 21, 2024
Details
- NPI
- 1265216683
- Entity type
- Organization (NPI-2)
- Legal business name
- Edge Treatment LLC
- Organization subpart
- No
- Enumeration date
- Aug 24, 2023
- Certification date
- Oct 4, 2024
- Last updated
- Oct 21, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 324500000X | Substance Abuse Rehabilitation Facility | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 261QM1300X | Clinic/Center, Multi-Specialty | – | – | |
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – |
Practice location
11205 Alpharetta Hwy Ste H4Roswell, GA 30076-5649
Phone 706-342-6024
Mailing address
11205 Alpharetta Hwy Ste H4Roswell, GA 30076-5649
Authorized official
Joshua Jarvis
Ceo
7063426024
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