MEDICARE: CURTIS BEHAVIORAL HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1942852512
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CURTIS BEHAVIORAL HEALTH

Provider Business Mailing Address
First Line	:	2052 WATSON BLVD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-3625
Country	:	US
Telephone Number	:	478-207-7773
Fax Number	:	877-299-6815

Provider Business Practice Location Address
First Line	:	2052 WATSON BLVD
Second Line	:
City	:	WARNER ROBINS
State	:	GA
Zip	:	31093-3625
Country	:	US
Telephone Number	:	478-207-7773
Fax Number	:	877-299-6815

Authorized Official
Title or Position	:	OWNER
Name	:	MARION CURTIS
Credential	:
Telephone Number	:	478-207-7773

Provider Enumeration Date	:	07/12/2019
Last Update Date	:	01/06/2021

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