| Organization Name: | SOUTHEAST TREATMENT CENTER LLC |
| NPI Number: | 1275718405 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBERT EARL WINDSOR (CEO/OWNER) |
| Mailing Address: | 88 Lindsey Ln Ste C Kingsland |
| State: | GA US |
| Postal Code: | 315486857 |
| Phone Number: | 9126737074 |
| Fax Number: | 9126736896 |
| NPI Enumeration Date: | 01/07/2008 |
| NPI Last Update Date: | 04/05/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |