Healthcare Provider Details

I. General information

NPI: 1437209665
Provider Name (Legal Business Name): OGEECHEE BEHAVIORAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 CLARKS MILL RD
LOUISVILLE GA
30434-5304
US

IV. Provider business mailing address

223 NORTH ANDERSON DRIVE P O BOX 1259
SWAINSBORO GA
30401
US

V. Phone/Fax

Practice location:
  • Phone: 478-625-7214
  • Fax: 478-625-7240
Mailing address:
  • Phone: 478-289-2522
  • Fax: 478-289-2544

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: J. FRANK BRANTLEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 478-289-2522