Organization
PEACHSTATE BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE THOMAS M.ED. (EXECUTIVE DIRECTOR)
(706) 726-4711
Entity
Organization
Contact information
Practice address
233 DAVIS RD, SUITE G, AUGUSTA, GA 30907-2499
(706) 726-4711
Mailing address
2421 CENTRAL AVE, SUITE A, AUGUSTA, GA 30904-6295
(706) 726-0365
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281814287A
—
GA
Enumeration date
12/09/2009
Last updated
12/09/2009
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