Healthcare Provider Details

I. General information

NPI: 1366619652
Provider Name (Legal Business Name): ALARIS BEHAVIORAL SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 07/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 HABERSHAM DR SUITE 146
FAYETTEVILLE GA
30214-1381
US

IV. Provider business mailing address

110 HABERSHAM DR SUITE 146
FAYETTEVILLE GA
30214-1381
US

V. Phone/Fax

Practice location:
  • Phone: 770-371-5110
  • Fax: 678-500-6797
Mailing address:
  • Phone: 770-371-5110
  • Fax: 678-500-6797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number49070
License Number StateGA

VIII. Authorized Official

Name: DR. LINDA R. NEALE
Title or Position: PRESIDENT/MEDICAL DIRECTOR
Credential: D.O.
Phone: 770-716-4117