Provider Demographics
NPI:1265607683
Name:ASSERTIVE COMMUNITY RECOVERY, LLC
Entity type:Organization
Organization Name:ASSERTIVE COMMUNITY RECOVERY, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCALLISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-508-0078
Mailing Address - Street 1:2568 PARK CENTRAL BLVD
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-3916
Mailing Address - Country:US
Mailing Address - Phone:404-508-0078
Mailing Address - Fax:404-508-0071
Practice Address - Street 1:2568 PARK CENTRAL BLVD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-3916
Practice Address - Country:US
Practice Address - Phone:404-508-0078
Practice Address - Fax:404-508-0071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-27
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QM0850X, 251S00000X, 251S00000X
GA044-215-D261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA050029051CMedicaid
GA050029051AMedicaid
GA050029051BMedicaid