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General NPI Number Information
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NPI Number | 1083426332
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Entity Type | Organization
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Legal Business Name | SAMBA BEHAVIORAL HEALTH AT PEACHTREE
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Dates
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Enumeration Date | 01/23/2025
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 155 TECHNOLOGY PKWY STE 400
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City | NORCROSS
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State | GA
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Zip | 30092-2969
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Country | US
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Telephone | 732-642-1610
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Fax |
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Provider Business Mailing Address
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Address Line | 250 CEDARBRIDGE AVE STE 290
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4236
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Country | US
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Telephone | 732-642-1610
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSHUA BAMBERGER
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Credential |
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Telephone | 732-642-1610
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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