Healthcare Provider Details

I. General information

NPI: 1083787394
Provider Name (Legal Business Name): BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 INDUSTRIAL PARK DR
ADEL GA
31620-3446
US

IV. Provider business mailing address

3120 N OAK STREET EXT STE C
VALDOSTA GA
31602-5910
US

V. Phone/Fax

Practice location:
  • Phone: 229-896-4559
  • Fax: 229-896-8367
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MRS. JANE B. STEPHENS
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CPA
Phone: 229-671-6108