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SOUTHEAST DETOX LLC
NPI 1710652052
Substance Abuse Rehabilitation Facility in Rome, GA

Active since August 10, 2021CLIA 11D2223915 · Waiver
4300 MARTHA BERRY HWY NE, ROME, GA 30165(770) 217-7832 Get Directions Write a Review

NPPES record last updated: August 10, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Southeast Detox Llc NPPES

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

SOUTHEAST DETOX LLC (NPI 1710652052) is a healthcare organization registered as a substance abuse rehabilitation facility in Rome, Georgia and active in the NPI registry since August 2021. The organization holds a CLIA Waiver certificate valid through May 10, 2027 and lists Ryan Welch, Partner, as its authorized official.

NPPES Registry Identity

NPI1710652052
Entity TypeOrganization
Primary Taxonomy324500000X
Legal Business NameSOUTHEAST DETOX LLC
Location Address4300 MARTHA BERRY HWY NERome, GA 30165-8642
Mailing Address2328 10th Ave N Ste 202Lake Worth, FL 33461-6612 · (561) 990-9951
Phone(770) 217-7832
Organization SubpartNo
Authorized OfficialRyan WelchPartner · (770) 217-7832
Enumeration DateAugust 10, 2021
NPPES CertifiedAugust 10, 2021
✔ NPI 1710652052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySubstance Abuse Rehabilitation FacilityResidential Treatment Facilities
Taxonomy Code324500000X
Definition

A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.

4300 MARTHA BERRY HWY NE, Rome, GA 30165
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

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 11D2223915

Southeast Detox, LLC · Rome, GA
Active · expires May 10, 2027
CLIA Number11D2223915
Laboratory TypeResidential Detox Ctr
Certificate Effective DateMay 11, 2025
Certificate Expiration DateMay 10, 2027
Laboratory DirectorRyan Welch
Laboratory Phone(770) 217-7832
Laboratory LocationSoutheast Detox, LLC4300 Martha Berry Highway, Rome, GA 30165
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FOUR-SIXTY INC
Hospice, Inpatient
4300 MARTHA BERRY HWY NE
ROME, GA 30165
Floyd County (678) 834-7615
MT BERRY HOSPICE INC.
Hospice, Inpatient
4300 MARTHA BERRY HWY NE
ROME, GA 30165
Floyd County (706) 232-1571

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 Southeast Detox LLC's NPI number?

The NPI number for Southeast Detox LLC is 1710652052. It was assigned to this organization in the NPPES registry on August 10, 2021.

Where is Southeast Detox LLC located?

Southeast Detox LLC is located at 4300 Martha Berry Hwy NE, Rome, GA 30165. The listed phone number is (770) 217-7832.

What is Southeast Detox LLC's specialty?

The primary specialty registered for this NPI is Substance Abuse Rehabilitation Facility with taxonomy code 324500000X.

Does Southeast Detox LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2223915) is associated with this NPI, valid through May 10, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Southeast Detox LLC accept?

Health plans from Alliant Health Plans, Inc. list Southeast Detox LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Southeast Detox LLC was last updated on August 10, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.