Organization · NPI-2

Advanced Behavioral Health Services Of Tifton

Clinic/Center, Mental Health (Including Community Mental Health Center) · Tifton, GA

NPI number1134812134
StatusActive
Last updated in NPPESMay 26, 2023

Details

NPI
1134812134
Entity type
Organization (NPI-2)
Legal business name
Advanced Behavioral Health Services Of Tifton
Organization subpart
No
Enumeration date
May 26, 2023
Certification date
May 26, 2023
Last updated
May 26, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––Yes
251S00000X Community/Behavioral Health––

Practice location

16 Library Ln
Tifton, GA 31794-4415

Phone 229-396-5885

Mailing address

16 Library Ln
Tifton, GA 31794-4415

Phone 229-396-5885

Authorized official

Jennifer Iverson
Lcsw/Owner
6622420122

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