Organization · NPI-2

Dominion Behavioral Health Services LLC

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

NPI number1326674060

StatusActive

Last updated in NPPESOct 28, 2022

Details

NPI: 1326674060
Entity type: Organization (NPI-2)
Legal business name: Dominion Behavioral Health Services LLC
Organization subpart: No
Enumeration date: Mar 13, 2020
Certification date: Mar 13, 2020
Last updated: Oct 28, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
261QM0801X	Clinic/Center, Mental Health (Including Community Mental Health Center)	–	–	Yes
273R00000X	Psychiatric Unit	–	–
3104A0625X	Assisted Living Facility, Assisted Living, Mental Illness	–	–
3104A0630X	Assisted Living Facility, Assisted Living, Behavioral Disturbances	–	–
323P00000X	Psychiatric Residential Treatment Facility	–	–
261QR0405X	Clinic/Center, Rehabilitation, Substance Use Disorder	–	–
251S00000X	Community/Behavioral Health	–	–
253Z00000X	In Home Supportive Care	–	–
261QH0100X	Clinic/Center, Health Services	–	–
261QM0850X	Clinic/Center, Adult Mental Health	–	–
261QM0855X	Clinic/Center, Adolescent and Children Mental Health	–	–
324500000X	Substance Abuse Rehabilitation Facility	–	–
3245S0500X	Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children	–	–

Practice location

817 Prairie Lane
Evans, GA

Phone 804-218-1993

Mailing address

817 Prairie Lane
Evans, GA

Authorized official

Anthony Onoh
Dnp, Psych NP
8042181993

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