MEDICARE: PREFERRED BEHAVIORAL HEALTH AGENCY

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	:	1831841543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED BEHAVIORAL HEALTH AGENCY

Provider Business Mailing Address
First Line	:	6000 STEWART PKWY UNIT 5646
Second Line	:
City	:	DOUGLASVILLE
State	:	GA
Zip	:	30154-1109
Country	:	US
Telephone Number	:	702-518-6632
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 N TENAYA WAY
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0420
Country	:	US
Telephone Number	:	702-518-6632
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DJUAN L WILLIAMS
Credential	:
Telephone Number	:	702-518-6632

Provider Enumeration Date	:	01/24/2022
Last Update Date	:	08/20/2025

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Directions to “PREFERRED BEHAVIORAL HEALTH AGENCY ” Practice Location

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