KINGSTON WELLNESS RETREAT LLC
NPI 1497551337
Psychiatric Residential Treatment Facility in Kingston, GA

Active since February 21, 2025CLIA 11D2325245 · Waiver
45 E HOWARD ST, KINGSTON, GA 30145(561) 797-3264 Get Directions Write a Review

NPPES record last updated: November 26, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 26, 2025, Feb 21, 2025 (2 updates tracked since 2025).

About Kingston Wellness Retreat Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KINGSTON WELLNESS RETREAT LLC (NPI 1497551337) is a healthcare organization registered as a psychiatric residential treatment facility in Kingston, Georgia and active in the NPI registry since February 2025. The organization holds a CLIA Waiver certificate valid through June 9, 2027 and lists Danielle Craig, Vp Facility Operations, as its authorized official.

NPPES Registry Identity

NPI1497551337
Entity TypeOrganization
Primary Taxonomy323P00000X
Legal Business NameKINGSTON WELLNESS RETREAT LLC
Location Address45 E HOWARD STKingston, GA 30145-3003
Mailing Address100 Governors Trce Ste 101Peachtree City, GA 30269-4853
Organization SubpartNo
Authorized OfficialDanielle CraigVp Facility Operations · (561) 797-3264
Enumeration DateFebruary 21, 2025
Last NPPES UpdateNovember 26, 20252 updates tracked since enumeration
NPPES CertifiedNovember 26, 2025
NPI 1497551337 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyPsychiatric Residential Treatment FacilityResidential Treatment Facilities
Taxonomy Code323P00000X
Definition
A residential treatment facility (RTF) is a facility or distinct part of a facility that provides to children and adolescents, a total, twenty-four hour, therapeutically planned group living and learning situation where distinct and individualized psychotherapeutic interventions can take place. Residential treatment is a specific level of care to be differentiated from acute, intermediate, and long-term hospital care, when the least restrictive environment is maintained to allow for normalization of the patient's surroundings. The RTF must be both physically and programmatically distinct if it is a part or subunit of a larger treatment program. An RTF is organized and professionally staffed to provide residential treatment of mental disorders to children and adolescents who have sufficient intellectual potential to respond to active treatment (that is, for whom it can reasonably be assumed that treatment of the mental disorder will result in an improved ability to function outside the RTF) for whom outpatient treatment, partial hospitalization or protected and structured environment is medically or psychologically necessary
Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X
Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X
45 E HOWARD ST, Kingston, GA 30145

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2325245

Kingston Wellness Retreat · Kingston, GA
Active · expires Jun 9, 2027
CLIA Number11D2325245
Laboratory TypeIndependent
Certificate Effective DateJune 10, 2025
Certificate Expiration DateJune 9, 2027
Laboratory DirectorBryon Mcquirt
Laboratory Phone(770) 884-6535
Laboratory LocationKingston Wellness Retreat45 E Howard Street, Kingston, GA 30145
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kingston Wellness Retreat LLC's NPI number?

The NPI number for Kingston Wellness Retreat LLC is 1497551337. It was assigned to this organization in the NPPES registry on February 21, 2025.

Where is Kingston Wellness Retreat LLC located?

Kingston Wellness Retreat LLC is located at 45 E Howard St, Kingston, GA 30145. The listed phone number is (561) 797-3264.

What is Kingston Wellness Retreat LLC's specialty?

The primary specialty registered for this NPI is Psychiatric Residential Treatment Facility with taxonomy code 323P00000X.

Does Kingston Wellness Retreat LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2325245) is associated with this NPI, valid through June 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Kingston Wellness Retreat LLC was last updated on November 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.