WILLOW CREEK SUBSTANCE ABUSE PROGRAM (NPI# 1427290261) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427290261 |
| Entity Type | Organization |
| Organization Name | WILLOW CREEK SUBSTANCE ABUSE PROGRAM |
| Practice Address |
10 Kiker St Ellijay GA 30540-3700 |
| Practice Telephone | 7066362692 |
| Practice Fax Number | 7606362694 |
| Mailing Telephone | 7066362692 |
| Mailing Fax Number | 7606362694 |
| Enumeration Date | 2009-03-25 |
| Last Update Date | 2009-03-25 |
| Authorized Official Name | LARRY W HOOKS (DIRECTOR) |
| Authorized Official Telephone | 7066362692 |
| Authorized Official Credential | LPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
LPC003706 | GA | Ambulatory Health Care Facilities |
| Street Address |
10 KIKER ST |
| City | ELLIJAY |
| State | GA |
| Zip Code | 30540-3700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407919889 | Larry Hooks | Counselor | 10 Kiker St, Ellijay, GA 30540-3700 | 2006-12-18 |
| 1114174331 | Willow Creek Adolescent Substance Abuse Program | Counselor | 10 Kiker St, Ellijay, GA 30540-3700 | 2008-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760929517 | Sandi Lynn Harris | Pharmacist | 192 1st St, East Ellijay, GA 30540 | 2017-01-31 |
| 1194028688 | Heartlite Hospice Ellijay, Inc. | Hospice Care, Community Based | 163 Dalton Street, East Ellijay, GA 30540 | 2010-12-06 |
| 1972816874 | Nicole Penland Bond | Nurse Practitioner | 174 Highland Crossing East, East Ellijay, GA 30540 | 2010-07-20 |
| 1689994477 | Immediate Medcare, LLC | Clinic/Center | 174 Highland Crossing South, East Ellijay, GA 30540 | 2010-06-03 |
| 1316274830 | Huffs Select Care Clinic PC | Clinic/Center | 136-a Industrial Blvd, Ellijay, GA 30540 | 2009-11-04 |
| 1598924615 | Hospice Advantage, LLC. | Hospice Care, Community Based | 583 Highland Xing, Suite 120, East Ellijay, GA 30540 | 2008-06-04 |
| 1083891196 | Roy Elie Abrahamian | Internal Medicine | 309 Highland Pkwy Ste 200, East Ellijay, GA 30540 | 2008-01-31 |
| 1285817213 | Quality Respi-care Inc | Durable Medical Equipment & Medical Supplies | 97 Hefner St Ste 102, East Ellijay, GA 30540 | 2007-12-13 |
| 1275738163 | Jennifer Moss Houle | Technician, Other | 7 Depot Street, Ellijay, GA 30540 | 2007-06-19 |
| 1265633697 | Alicia S Lovelace | Specialist | 630 Blazing Star Rd, Ellijay, GA 30540 | 2007-05-31 |
| Find all providers in zip 30540 | ||||
| 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 | ||||
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| 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.