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General NPI Number Information
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NPI Number | 1336917707
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Entity Type | Organization
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Legal Business Name | BUCKHEAD BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 12/15/2023
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 365 MARKET PL STE 201
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City | ROSWELL
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State | GA
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Zip | 30075-3947
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Country | US
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Telephone | 770-230-5699
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Fax |
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Provider Business Mailing Address
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Address Line | 365 MARKET PL STE 201
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City | ROSWELL
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State | GA
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Zip | 30075-3947
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Country | US
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Telephone | 770-230-5699
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF QUALITY ASSURANCE
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Name | ERIKA DALTON
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Credential |
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Telephone | 470-226-6002
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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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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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