Healthcare Provider Details

I. General information

NPI: 1861325151
Provider Name (Legal Business Name): RIVER EDGE BEHAVIORAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 BROWNS CROSSING RD NW
HADDOCK GA
31033-2012
US

IV. Provider business mailing address

175 EMERY HWY
MACON GA
31217-3692
US

V. Phone/Fax

Practice location:
  • Phone: 478-932-5893
  • Fax:
Mailing address:
  • Phone: 478-803-7809
  • Fax: 478-803-8598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JESSICA OAKES
Title or Position: BILLING DIRECTOR, ECR SYSTEM ADMIN
Credential:
Phone: 478-803-7809