MEDICARE: RIVER EDGE BEHAVIORAL HEALTH CENTER

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1467385757
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER EDGE BEHAVIORAL HEALTH CENTER

Provider Business Mailing Address
First Line	:	175 EMERY HWY
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31217-3692
Country	:	US
Telephone Number	:	478-803-7600
Fax Number	:	478-803-8598

Provider Business Practice Location Address
First Line	:	461 E MONTGOMERY ST
Second Line	:
City	:	MILLEDGEVILLE
State	:	GA
Zip	:	31061-3008
Country	:	US
Telephone Number	:	478-445-4362
Fax Number	:

Authorized Official
Title or Position	:	BILLING DIRECTOR, ECR SYSTEM ADMIN
Name	:	JESSICA OAKES
Credential	:
Telephone Number	:	478-803-7809

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/05/2026

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