Organization

Willow Creek Adolescent Substance Abuse Program

Addiction (Substance Use Disorder) Counselor in Ellijay, GA(View on Map)

Legal Business Name

Willow Creek Adolescent Substance Abuse Program

NPI Number

1114174331

NPI Type

Organization

Enumeration Date

08/19/2008

Specialties

(Taxonomies)

Code

101YA0400X

Primary Taxonomy

Yes

Licenses

State

Georgia

License Number

LPC003706

Contact
Information

Purpose

Mailing
Location

Address

10 KIKER ST
10 KIKER ST

City

Ellijay
Ellijay

State

GA
GA

Postal Code

30540-3700
30540-3700

Country

US
US

Telephone Number

(706) 636-2692
(706) 636-2692

Authorized Official

Name

Mr. Larry Hooks

Title or Position

CEO AND DIRECTOR

Telephone Number

(706) 636-2692

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/19/2008

Provider Address