Provider Demographics
NPI:1912371196
Name:SUMMIT BHC MONROE, LLC
Entity Type:Organization
Organization Name:SUMMIT BHC MONROE, LLC
Other - Org Name:TWIN LAKES RECOVERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF LEGAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-716-4924
Mailing Address - Street 1:204 W ACADEMY ST SW
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3557
Mailing Address - Country:US
Mailing Address - Phone:770-540-1112
Mailing Address - Fax:888-418-7712
Practice Address - Street 1:204 W ACADEMY ST SW
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3557
Practice Address - Country:US
Practice Address - Phone:770-540-1112
Practice Address - Fax:888-418-7712
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT BEHAVIORAL HEALTHCARE. LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-25
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility