POTTERS HANDS INSTITUTE LLC (NPI# 1386964690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386964690 |
| Entity Type | Organization |
| Organization Name | POTTERS HANDS INSTITUTE LLC |
| Practice Address |
307 Old Stone Rd Villa Rica GA 30180-1214 |
| Practice Telephone | 7704598799 |
| Practice Fax Number | 7704598919 |
| Mailing Telephone | 7704598799 |
| Mailing Fax Number | 7704598919 |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2010-06-09 |
| Authorized Official Name | DR. MOBOLAJI OYEBANJO (CEO) |
| Authorized Official Telephone | 7704598799 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
DRUG000750 | GA | Ambulatory Health Care Facilities |
| Street Address |
307 OLD STONE RD |
| City | VILLA RICA |
| State | GA |
| Zip Code | 30180-1214 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578754503 | Omobolaji Oluseyi Oyebanjo Popoola | Psychiatry & Neurology | 307 Old Stone Rd, Villa Rica, GA 30180-1214 | 2007-08-06 |
| 1740769538 | Khadeja Chowdhury | Physician Assistant | 307 Old Stone Rd, Villa Rica, GA 30180 | 2018-08-13 |
| 1760932685 | Mardeea Jartu | Counselor | 307 Old Stone Rd, Villa Rica, GA 30180-1214 | 2016-10-04 |
| 1700209327 | Larry Dewitt Fuller Jr. | Counselor | 307 Old Stone Rd, Villa Rica, GA 30180-1214 | 2014-02-03 |
| 1881967677 | April C Thomas | Counselor | 307 Old Stone Rd, Villa Rica, GA 30180-1214 | 2012-02-09 |
| 1922280684 | Mobolaji Shalom Oyebanjo, Inc | Clinic/Center | 307 Old Stone Rd, Villa Rica, GA 30180-1214 | 2007-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174161624 | Crucible Communication Therapy LLC | Speech-Language Pathologist | 9765 Walnut Grove Trail, Villa Rica, GA 30180 | 2019-12-16 |
| 1366802845 | Medic-pearl, LLC | Ambulance | 1108 Charter Oak Ct, Villa Rica, GA 30180 | 2016-02-26 |
| 1396138368 | Josette Etienne | Nurse Practitioner | 403 Permian Way Suite A, Villa Rica, GA 30180 | 2015-03-13 |
| 1447690516 | Judith L.m. Thigpen | Nurse Practitioner | 736 Highway 78 West, Minute Clinic, Villa Rica, GA 30180 | 2013-07-03 |
| 1477890168 | Wesley Douglas Mckenzie | Pharmacist | 2500 Mirror Lake Blvd, Villa Rica, GA 30180 | 2013-01-15 |
| 1497005359 | Malika Remie Rajendra | Optometrist | 600 Hwy 61, Villa Rica, GA 30180 | 2012-09-18 |
| 1972876449 | Catherine Elaine Tyson | Pharmacist | 601 Dallas Road, Villa Rica, GA 30180 | 2012-02-14 |
| 1619262433 | Villa Rica Rx LLC | Pharmacy | 222 West Wilson Street, Villa Rica, GA 30180 | 2011-06-09 |
| 1851602874 | Jules Chopin Sybert | Nurse Practitioner | 736 W. Bankhead Hwy, Villa Rica, GA 30180 | 2010-06-24 |
| 1487984019 | Lisa Wood | Occupational Therapy Assistant | 1207 Woods Walk, Villa Rica, GA 30180 | 2010-01-04 |
| Find all providers in zip 30180 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497217715 | Peachtree Recovery Centers, LLC | Clinic/Center | 3975 Roswell Rd Ne Ste 104, Atlanta, GA 30342-4119 | 2019-04-04 |
| 1902374812 | Centered Recovery Programs, LLC | Clinic/Center | 1000 Piedmont Rd, Marietta, GA 30066-4032 | 2018-11-08 |
| 1255816302 | Brainscience Recovery.works | Clinic/Center | 4233 Pleasant Hill Rd Ste 110, Duluth, GA 30096-1609 | 2018-09-25 |
| 1619469665 | First Georgia Counseling Services LLC | Clinic/Center | 921 W Taylor St, Griffin, GA 30223-2605 | 2018-06-05 |
| 1952899775 | Manifest Recovery | Clinic/Center | 1215 Hightower Trl Ste 201, Sandy Springs, GA 30350-6244 | 2018-04-26 |
| 1003317538 | East Point Recovery Center | Clinic/Center | 100 Governors Trce Ste 110, Peachtree City, GA 30269-4853 | 2018-02-21 |
| 1538671011 | Summit Wellness Group, Inc | Clinic/Center | 745 Hembree Pl, Roswell, GA 30076-4035 | 2017-10-24 |
| 1891214375 | Centered Recovery Programs, LLC | Clinic/Center | 1250 Upper Hembree Rd Ste E, Roswell, GA 30076-4651 | 2017-09-15 |
| 1386009520 | Georgia Detox and Recovery, LLC | Clinic/Center | 2812 Hillcreek Dr Ste B, Augusta, GA 30909-5632 | 2015-12-15 |
| 1427424183 | Trek Medical, LLC | Clinic/Center | 5895 Windward Parkway, Suite 150, Alpharetta, GA 30005 | 2015-08-18 |
| Find all providers with the same taxonomy | ||||
| City | VILLA RICA |
| Zip Code | 30180 |
Please comment or provide details below to improve the information on POTTERS HANDS INSTITUTE LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.