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General NPI Number Information
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NPI Number | 1164551503
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Entity Type | Organization
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Legal Business Name | MAGELLAN HEALTHCARE SERVICES
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Dates
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Enumeration Date | 03/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2550 NORTHWINDS PKWY
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City | ALPHARETTA
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State | GA
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Zip | 30004-2241
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Country | US
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Telephone | 800-201-8316
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Fax |
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Provider Business Mailing Address
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Address Line | 2785 OAK MEADOW DR
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City | SNELLVILLE
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State | GA
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Zip | 30078-2794
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Country | US
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Telephone | 770-736-9988
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Fax |
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Authorized Official
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Title or Position | SUPERVISOR
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Name | MR. NISHMA HERRERA-DAYA
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Credential | LMSW
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Telephone | 800-201-8316
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 002776
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License Number State | GA
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