Provider Demographics
NPI:1710385372
Name:JOURNEY THROUGH RECOVERY TO WELLNESS, LLC
Entity Type:Organization
Organization Name:JOURNEY THROUGH RECOVERY TO WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAKEISHA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:VARNER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:770-765-3252
Mailing Address - Street 1:217 ARROWHEAD BLVD STE A2
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-1169
Mailing Address - Country:US
Mailing Address - Phone:770-765-3252
Mailing Address - Fax:
Practice Address - Street 1:217 ARROWHEAD BLVD STE A2
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-1169
Practice Address - Country:US
Practice Address - Phone:770-765-3252
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2014-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006967251K00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003152492AMedicaid