Healthcare Provider Details

I. General information

NPI: 1407772403
Provider Name (Legal Business Name): BEHAVIORAL HEALTH OF PERRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1026 KEITH DR
PERRY GA
31069-2947
US

IV. Provider business mailing address

1026 KEITH DR
PERRY GA
31069-2947
US

V. Phone/Fax

Practice location:
  • Phone: 704-472-5937
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: BRIAN PAYNE
Title or Position: CEO
Credential:
Phone: 770-560-6336