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General NPI Number Information
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NPI Number | 1194055046
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Entity Type | Organization
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Legal Business Name | OGEECHEE BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 12/28/2009
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Last Update Date | 12/28/2009
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Provider Practice Location Address
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Address Line | 566 HWY 25 S
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City | WAYNESBORO
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State | GA
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Zip | 30830-5545
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Country | US
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Telephone | 706-437-6854
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Fax |
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Provider Business Mailing Address
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Address Line | 223 N ANDERSON DR P O BOX 1259
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City | SWAINSBORO
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State | GA
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Zip | 30401-4440
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Country | US
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Telephone | 478-289-2522
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | VICTORIA RICHBOURG
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Credential | LPC
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Telephone | 478-289-2522
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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 |
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