NPI age
5 years
Enumerated 2021-04-22
● Active Type 2 · Organization
Subpart
Atlanta Detox Center, Llc
Atlanta Detox Center, Llc is 1 of 662 clinic/center organizations in Georgia.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Costley
Licensing And Credentialing Special
Last NPPES update
2021-04-22
Source: monthly bulk 2026-05
How this organization compares
Across 662 active clinic/center providers in Georgia.
NPI age
5 years
≈ at median (5 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2021 → 2026
2021-04Enumerated in NPPES
2021
2026
Where they practice
Primary practice location
277 Medical Way
Riverdale, GA 302742522
Mailing address
277 Medical Way
Riverdale, GA 302742522
Authorized official
Jessie Costley
Licensing And Credentialing Special
📞 4108078471
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Scott Gibson, LPN Licensed Practical Nurse NPI 1083371538
- Robyn Goodart Counselor NPI 1063186039
- Lequawn James Nurse Practitioner NPI 1154834406
- Akili Penn Licensed Practical Nurse NPI 1225706914
- Kate Rotimi-Samuel, RN Registered Nurse NPI 1538837224
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Multi-provider organization. 5 individual providers on file at this primary address.
Subpart of Atlanta Detox Center, Llc.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.