Healthcare Provider Details

I. General information

NPI: 1679647473
Provider Name (Legal Business Name): BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

334 TIFTON ELDORADO RD
TIFTON GA
31794-9497
US

IV. Provider business mailing address

334 TIFTON ELDORADO RD
TIFTON GA
31794-9497
US

V. Phone/Fax

Practice location:
  • Phone: 229-391-2280
  • Fax: 229-386-7400
Mailing address:
  • Phone: 229-391-2280
  • Fax: 229-386-7400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM F HULING
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CPA
Phone: 229-671-6140