Provider Demographics
NPI:1275765307
Name:TALBOTT RECOVERY CAMPUS
Entity Type:Organization
Organization Name:TALBOTT RECOVERY CAMPUS
Other - Org Name:TALBOTT AT DUNWOODY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SR VP CFO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-768-3300
Mailing Address - Street 1:4480 N SHALLOWFORD RD STE 224
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6410
Mailing Address - Country:US
Mailing Address - Phone:404-952-2500
Mailing Address - Fax:770-454-5575
Practice Address - Street 1:4480 N SHALLOWFORD RD STE 224
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6410
Practice Address - Country:US
Practice Address - Phone:404-952-2500
Practice Address - Fax:770-454-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADRUG12459261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder