Provider Demographics
NPI:1093338816
Name:SUMMIT WELLNESS GROUP WITH FLAIRE INC
Entity Type:Organization
Organization Name:SUMMIT WELLNESS GROUP WITH FLAIRE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHALIT
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:678-859-7244
Mailing Address - Street 1:745 HEMBREE PL
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4035
Mailing Address - Country:US
Mailing Address - Phone:561-317-4563
Mailing Address - Fax:770-299-1249
Practice Address - Street 1:996 HUFF RD NW STE C
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-4333
Practice Address - Country:US
Practice Address - Phone:770-299-1677
Practice Address - Fax:772-991-1249
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA20076174OtherPRIVATE FOR PROFIT