| Assertive Community Recovery, Llc | |
|
2568 Park Central Blvd Decatur GA 30035-3916 | |
| (404) 508-0078 | |
| (404) 508-0071 |
| Full Name | Assertive Community Recovery, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2568 Park Central Blvd, Decatur, Georgia |
| Authorized Official Name and Position | Frank S Mcallister (CEO) |
| Authorized Official Contact | 4045080078 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Assertive Community Recovery, Llc 2568 Park Central Blvd Decatur GA 30035-3916 Ph: (404) 508-0078 | Assertive Community Recovery, Llc 2568 Park Central Blvd Decatur GA 30035-3916 Ph: (404) 508-0078 |
| NPI Number | 1265607683 |
|---|---|
| Provider Enumeration Date | 04/27/2008 |
| Last Update Date | 09/09/2021 |
| Certification Date | 09/09/2021 |
| Medicare PECOS PAC ID | 6709055817 |
|---|---|
| Medicare Enrollment ID | O20140306001781 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265607683 | NPI | - | NPPES |
| 050029051C | Medicaid | GA | |
| 050029051A | Medicaid | GA | |
| 050029051B | Medicaid | GA |
| Provider Name | Dennis Arthur O'brien |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043250079 PECOS PAC ID: 9537124177 Enrollment ID: I20080519000491 |
| Provider Name | Jocelyn R Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770706111 PECOS PAC ID: 7618945569 Enrollment ID: I20171005002251 |
| Provider Name | Matachi M Ughwanogho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639677529 PECOS PAC ID: 0042546152 Enrollment ID: I20190726002913 |
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