Provider Demographics
NPI:1891346060
Name:ZION COMMUNITY RECOVERY, INC.
Entity Type:Organization
Organization Name:ZION COMMUNITY RECOVERY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:STAPLETON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC, MAC
Authorized Official - Phone:770-912-8901
Mailing Address - Street 1:9278 DEER CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-5193
Mailing Address - Country:US
Mailing Address - Phone:770-912-8901
Mailing Address - Fax:678-489-7147
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:770-912-8901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty