Healthcare Provider Details

I. General information

NPI: 1679992424
Provider Name (Legal Business Name): NURSING & BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 07/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4525 FLAT SHOALS PKWY
DECATUR GA
30034-5038
US

IV. Provider business mailing address

4525 FLAT SHOALS PKWY
DECATUR GA
30034-5038
US

V. Phone/Fax

Practice location:
  • Phone: 404-600-8675
  • Fax: 800-766-1168
Mailing address:
  • Phone: 404-600-8675
  • Fax: 800-766-1168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: ERNEST GRANT FLAGG
Title or Position: PRESIDENT & CEO
Credential: RN, MPA, BS, DDP
Phone: 404-553-1929