Healthcare Provider Details

I. General information

NPI: 1235762998
Provider Name (Legal Business Name): REFOCUS BEHAVIOR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2020
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 E GENERAL STEWART WAY
HINESVILLE GA
31313-2634
US

IV. Provider business mailing address

740 E GENERAL STEWART WAY STE 103
HINESVILLE GA
31313-2636
US

V. Phone/Fax

Practice location:
  • Phone: 877-321-2899
  • Fax:
Mailing address:
  • Phone: 877-321-2899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMIE REDDING
Title or Position: OWNER
Credential: DBH, BCBA
Phone: 912-318-4253