Provider Demographics
NPI:1902374812
Name:CENTERED RECOVERY PROGRAMS, LLC
Entity Type:Organization
Organization Name:CENTERED RECOVERY PROGRAMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LUCAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-410-4894
Mailing Address - Street 1:1000 PIEDMONT RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-4032
Mailing Address - Country:US
Mailing Address - Phone:678-324-0593
Mailing Address - Fax:
Practice Address - Street 1:1000 PIEDMONT RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-4032
Practice Address - Country:US
Practice Address - Phone:678-324-0593
Practice Address - Fax:678-324-0952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA033-528-DOtherDATEP LICENSE THROUGH DCH