Organization
AVENIA BEHAVIORAL MANAGEMENT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL E BROWN JR. M,D. (OWNER, MEDICAL DIRECTOR)
(404) 316-4992
Entity
Organization
Contact information
Practice address
4500 KARLS GATE DR, MARIETTA, GA 30068-2017
(770) 973-0687
(770) 973-3587
Mailing address
2001 MLK JR DR SW STE, SUITES 418/420, ATLANTA, GA 30310
(404) 564-4987
(404) 564-4988
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH7731
RR MEDICARE GROUP PIN
GA
01
—
CH7732
RR MEDICARE GROUP PIN
GA
Enumeration date
06/16/2006
Last updated
08/17/2018
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