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General NPI Number Information
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NPI Number | 1811122070
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES
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Dates
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Enumeration Date | 05/18/2009
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 3000 SCHATULGA RD
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City | COLUMBUS
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State | GA
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Zip | 31907-3117
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Country | US
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Telephone | 706-565-3694
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 SCHATULGA RD
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City | COLUMBUS
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State | GA
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Zip | 31907-3117
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Country | US
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Telephone | 706-565-3694
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Fax |
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Authorized Official
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Title or Position | MH / MR SERVICE DIRECTOR
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Name | MS. LISA SWEAT
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Credential |
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Telephone | 706-565-3694
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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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