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General NPI Number Information
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NPI Number | 1740425552
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Entity Type | Organization
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Legal Business Name | SALUS BEHAVIORAL HEALTH GEORGIA LLC
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Dates
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Enumeration Date | 12/08/2008
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Last Update Date | 12/08/2008
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Provider Practice Location Address
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Address Line | 1050 CROWN POINTE PKWY SUITE 295
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City | ATLANTA
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State | GA
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Zip | 30338-7707
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Country | US
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Telephone | 866-325-5434
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Fax | 866-325-5340
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Provider Business Mailing Address
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Address Line | 1050 CROWN POINTE PKWY SUITE 295
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City | ATLANTA
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State | GA
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Zip | 30338-7707
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Country | US
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Telephone | 866-325-5434
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Fax | 866-325-5340
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Authorized Official
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Title or Position | CEO
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Name | AMY SHAPIRO
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Credential |
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Telephone | 866-325-5434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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