Healthcare Provider Details

I. General information

NPI: 1043066194
Provider Name (Legal Business Name): SAINT MARYS BEHAVIORAL HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 12/06/2024
Certification Date: 12/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 MCDOWELL ST
SAINT MARYS GA
31558-9050
US

IV. Provider business mailing address

PO BOX 888386
ATLANTA GA
30356-0386
US

V. Phone/Fax

Practice location:
  • Phone: 404-951-6020
  • 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
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: BRETT SWIDER
Title or Position: CEO
Credential:
Phone: 404-951-6020