MEDICARE: BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA

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
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number	:	1144394941
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA

Provider Business Mailing Address
First Line	:	3120 N OAK STREET EXT STE C
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-5910
Country	:	US
Telephone Number	:	229-671-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	3120 N OAK STREET EXT STE B
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-5910
Country	:	US
Telephone Number	:	229-671-6164
Fax Number	:	229-671-6750

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MRS. JANE B. STEPHENS
Credential	:	CPA
Telephone Number	:	229-671-6108

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	10/08/2025

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Directions to “BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA ” Practice Location

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