# RIVER EDGE BEHAVIORAL HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** RIVER EDGE BEHAVIORAL HEALTH CENTER
- **Other names:** River Edge Boulevard Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1972085769
- **Legal business name:** RIVER EDGE BEHAVIORAL HEALTH CENTER
- **Authorized official:** JESSICA OAKES DO (BILLING MANAGER)
- **Authorized official phone:** (478) 803-7809

## Contact information

- **Practice address:** 265 BOULEVARD NE, ATLANTA, GA 30312-1208
- **Practice address phone:** (404) 665-8550
- **Practice address fax:** (404) 665-8693
- **Mailing address:** 175 EMERY HWY, MACON, GA 31217-3692
- **Mailing address phone:** (478) 803-7700
- **Mailing address fax:** (478) 803-8598

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | PHRE010434 | GA | Yes |

## Other

- **Enumeration date:** 08/29/2018
- **Last updated:** 08/29/2018