| Organization Name: | POTTERS HANDS INSTITUTE LLC |
| NPI Number: | 1386964690 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MOBOLAJI OYEBANJO (CEO) |
| Mailing Address: | 307 Old Stone Rd Villa Rica |
| State: | GA US |
| Postal Code: | 301801214 |
| Phone Number: | 7704598799 |
| Fax Number: | 7704598919 |
| NPI Enumeration Date: | 06/09/2010 |
| NPI Last Update Date: | 06/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | DRUG000750 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |