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NPI Code Detail

MEDICARE: TRAIME BEHAVIORAL HEALTH, INC

MEDICARE: TRAIME BEHAVIORAL HEALTH, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health Agency

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033435482
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRAIME BEHAVIORAL HEALTH, INC
Provider Business Mailing Address
First Line : 2020 HOWELL MILL RD NW
Second Line : SUITE C213
City : ATLANTA
State : GA
Zip : 30318-1732
Country : US
Telephone Number : 678-419-0222
Fax Number :
Provider Business Practice Location Address
First Line : 2020 HOWELL MILL RD NW
Second Line : SUITE C213
City : ATLANTA
State : GA
Zip : 30318-1732
Country : US
Telephone Number : 678-419-0222
Fax Number :
Authorized Official
Title or Position : CEO
Name : DR. VAL JACKSON
Credential :
Telephone Number : 678-419-0222
Provider Enumeration Date : 04/09/2010
Last Update Date : 04/09/2010

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Directions to “TRAIME BEHAVIORAL HEALTH, INC ” Practice Location

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