Acworth Outpatient Detox, LLC
Clinic/Center, Rehabilitation, Substance Use Disorder in Acworth, GA. Organization (NPI-2).
NPI number1497327720
StatusActive
Last updated in NPPESJun 24, 2022
Details
- NPI
- 1497327720
- Entity type
- Organization (NPI-2)
- Legal business name
- Acworth Outpatient Detox, LLC
- Organization subpart
- No
- Enumeration date
- Jul 15, 2021
- Certification date
- Jun 24, 2022
- Last updated
- Jun 24, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QR0405X | Clinic/Center, Rehabilitation, Substance Use Disorder | – | – | Yes |
| 261QR0800X | Clinic/Center, Recovery Care | – | – |
Practice location
6060 Lake Acworth Dr Nw Ste HAcworth, GA 30101-7358
Phone 229-560-8634
Mailing address
6060 Lake Acworth Dr Nw Ste HAcworth, GA 30101-7358
Authorized official
Jonathan Denker
Member
2295608634
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