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General NPI Number Information
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NPI Number | 1043471964
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Entity Type | Organization
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Legal Business Name | UNITED HEALTH AND BEHAVIORAL SERVICES, LLC
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Dates
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Enumeration Date | 06/23/2008
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 2272 AZALEA DR SUITE A
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-2630
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Country | US
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Telephone | 770-237-8345
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Fax | 866-830-3721
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Provider Business Mailing Address
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Address Line | 2272 AZALEA DR SUITE A
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-2630
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Country | US
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Telephone | 770-237-8345
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Fax | 866-830-3721
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MRS. NIKKI WILLIAMS
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Credential | AAS
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Telephone | 770-237-8345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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