Healthcare Provider Details

I. General information

NPI: 1528132321
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: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DELLWOOD CIR
VALDOSTA GA
31602-2335
US

IV. Provider business mailing address

3120 N OAK STREET EXT STE C
VALDOSTA GA
31602-5910
US

V. Phone/Fax

Practice location:
  • Phone: 229-506-6074
  • Fax: 229-506-6076
Mailing address:
  • Phone: 229-671-6100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. JANE B. STEPHENS
Title or Position: CHIEF FINANCIAL OFFICER
Credential: CPA
Phone: 229-671-6108