Provider Demographics
NPI:1871087981
Name:WESTLOND RECOVERY AND HOLISTIC COUNSELING CENTER
Entity type:Organization
Organization Name:WESTLOND RECOVERY AND HOLISTIC COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KECIS
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-769-8771
Mailing Address - Street 1:4115 COLUMBIA RD STE 183
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-0405
Mailing Address - Country:US
Mailing Address - Phone:678-435-9135
Mailing Address - Fax:
Practice Address - Street 1:1226 MARKS CHURCH ROAD
Practice Address - Street 2:SUITE F
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30909-1862
Practice Address - Country:US
Practice Address - Phone:404-769-8771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-21
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty