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General NPI Number Information
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NPI Number | 1093966160
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Entity Type | Organization
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Legal Business Name | YUC BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 5833 STEWART PKWY SUITE 201
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-6932
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Country | US
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Telephone | 404-564-9831
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Fax | 404-564-9837
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Provider Business Mailing Address
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Address Line | 777 CLEVELAND AVE SW SUITE 605
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City | ATLANTA
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State | GA
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Zip | 30315-7129
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Country | US
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Telephone | 404-564-9831
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Fax | 404-564-9837
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Authorized Official
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Title or Position | CEO
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Name | ANDREA PRICE
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Credential |
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Telephone | 404-564-9831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | GA
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