Organization · NPI-2

Behavioral Health Services Of South Georgia

Community/Behavioral Health · Tifton, GA

NPI number1255875910

StatusActive

Last updated in NPPESDec 14, 2016

Details

NPI: 1255875910
Entity type: Organization (NPI-2)
Legal business name: Behavioral Health Services Of South Georgia
Organization subpart: No
Enumeration date: Dec 14, 2016
Last updated: Dec 14, 2016

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
251S00000X	Community/Behavioral Health	MFT001515	GA	Yes

Practice location

334 Tifton Eldorado Rd
Tifton, GA 31794-9497

Phone 229-391-2301

Mailing address

3120 N Oak Street Ext
Suite C
Valdosta, GA 31602-5909

Phone 229-671-6700

Authorized official

Roz Johnson
Chief Clinical Officer
2296716700

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