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General NPI Number Information
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NPI Number | 1154959112
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Entity Type | Organization
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Legal Business Name | NURTURE BEHAVIORAL HEALTH AND EDUCATION SERVICES, LLC
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 08/12/2020
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Provider Practice Location Address
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Address Line | 1201 SHADOWLAWN DR STE 112
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City | SAINT MARYS
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State | GA
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Zip | 31558-4074
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Country | US
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Telephone | 912-409-7889
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Fax | 404-953-6258
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Provider Business Mailing Address
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Address Line | PO BOX 5042
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City | SAINT MARYS
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State | GA
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Zip | 31558-5042
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Country | US
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Telephone | 912-409-7889
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Fax | 404-953-6258
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Authorized Official
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Title or Position | OWNER/EXECUTIVE DIRECTOR
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Name | AMBER BROWN
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Credential | BCBA
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Telephone | 678-570-7417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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