Healthcare Provider Details

I. General information

NPI: 1871415935
Provider Name (Legal Business Name): BETA SIGNAL HEALTHCARE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 W POPLAR STREET SUITE J
GRIFFIN GA
30224
US

IV. Provider business mailing address

415 W POPLAR STREET SUITE J
GRIFFIN GA
30224
US

V. Phone/Fax

Practice location:
  • Phone: 470-449-4129
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name: BRIANCA HARDEN
Title or Position: PRESIDENT
Credential:
Phone: 470-449-4129