Organization
PHOENIX BEHAVIORAL EALTH SERVICES OF GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA MURRAH (CEO)
(770) 478-3417
Entity
Organization
Contact information
Practice address
8712 TARA BLVD, JONESBORO, GA 30236-4905
(770) 478-3417
(770) 478-3419
Mailing address
8712 TARA BLVD, JONESBORO, GA 30236-4905
(770) 478-3417
(770) 478-3419
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10037340
—
GA
05
—
137152
—
GA
Enumeration date
01/02/2007
Last updated
09/06/2007
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