Provider Demographics
NPI:1790515559
Name:SOBER NOTES ADDICTION COUNSELING LLC
Entity type:Organization
Organization Name:SOBER NOTES ADDICTION COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDELL
Authorized Official - Middle Name:ARMOND
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:LAPC
Authorized Official - Phone:678-215-3468
Mailing Address - Street 1:2467 ROSEBERRY LN
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-1555
Mailing Address - Country:US
Mailing Address - Phone:678-215-3468
Mailing Address - Fax:
Practice Address - Street 1:1194 147TH ST STE 5
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:GA
Practice Address - Zip Code:31064-8068
Practice Address - Country:US
Practice Address - Phone:678-215-3468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-06
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health