RENAISSANCE RECOVERY GROUP INC (NPI# 1881906386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881906386 |
| Entity Type | Organization |
| Organization Name | RENAISSANCE RECOVERY GROUP INC |
| Other Organization Name | NORTH FULTON TREATMENT CENTER |
| Practice Address |
601 Bombay Ln Roswell GA 30076-5828 |
| Practice Telephone | 7707544674 |
| Practice Fax Number | 7707544676 |
| Mailing Telephone | 7707544674 |
| Mailing Fax Number | 7707544676 |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2010-07-13 |
| Authorized Official Name | MRS. CASSANDRA WANZO (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 7707544674 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2800X |
Clinic/Center Specialization: Methadone Clinic |
NTP001016 | GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| North Fulton Treatment Center | Doing Business As Name - Organization |
| Street Address |
601 BOMBAY LN |
| City | ROSWELL |
| State | GA |
| Zip Code | 30076-5828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013060565 | Melissa Ragsdale Goodwin | Counselor | 601 Bombay Ln, Roswell, GA 30076-5828 | 2007-01-19 |
| 1679051460 | Nancy Barnett Aranson | Social Worker | 601 Bombay Ln, Roswell, GA 30076-5828 | 2018-08-02 |
| 1194203984 | Nancy Aranson, Lcsw, LLC | Clinic/Center | 601 Bombay Ln, Roswell, GA 30076-5828 | 2018-08-02 |
| 1376053314 | Ashley Lynn Phelps | Nurse Practitioner | 601 Bombay Ln, Roswell, GA 30076-5828 | 2017-10-04 |
| 1912383456 | Nona Ghazban | Counselor | 601 Bombay Ln, Roswell, GA 30076-5828 | 2015-08-06 |
| 1932475639 | Brandi Quinn | Nurse Practitioner | 601 Bombay Ln, Roswell, GA 30076-5828 | 2012-03-27 |
| 1922384320 | Dianne Stanford Johnson | Social Worker | 601 Bombay Ln, Roswell, GA 30076-5828 | 2011-10-29 |
| 1487936290 | Patricia Lynn Monahan | Counselor | 601 Bombay Ln, Roswell, GA 30076-5828 | 2011-09-16 |
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| 1841776689 | Scott Gunter Brunson | Hearing Instrument Specialist | 777 Old Roswell Pl # E100, Roswell, GA 30076 | 2018-07-16 |
| 1861998197 | Daniel B Charek | Clinical Neuropsychologist | 11685 Alpharetta Hwy Ste 170, Roswell, GA 30076 | 2018-04-04 |
| 1427575554 | A One Home Care, Inc. | In Home Supportive Care | 1875 Old Alabama Road, Suite 420, Roswell, GA 30076 | 2017-08-29 |
| 1053836023 | Madelon Morgan | Counselor | 555 Sun Valley Dr Bldg F, Roswell, GA 30076 | 2017-08-10 |
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| 1093163750 | Ryann Soutar | Counselor | 702 Macy Dr, Roswell, GA 30076 | 2016-06-02 |
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| Taxonomy Code | 261QM2800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Methadone Clinic |
| An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
| 1194104141 | Recovery Services of New Mexico | Clinic/Center | 1107 S Atkinson Ave, Roswell, NM 88203-7154 | 2015-05-22 |
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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.