| Organization Name: | TOXICOLOGY ASSOCIATES OF NORTH GEORGIA GWINNETT, INC. |
| NPI Number: | 1033440805 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CAROLYN KEELAGHAN (PROGRAM SPONSOR) |
| Mailing Address: | 1895 Beaver Ridge Cir Suite N Norcross |
| State: | GA US |
| Postal Code: | 300713840 |
| Phone Number: | 7702481616 |
| Fax Number: | 7702481618 |
| NPI Enumeration Date: | 01/19/2010 |
| NPI Last Update Date: | 01/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM2800X |
| License Number: | NTO001031 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Methadone Clinic |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |