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Organization

CARNEGIE BEHAVIORAL HEALTH SERVICES, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JONATHAN D HAUSER PHD (MEMBER)
(770) 716-6012
Entity
Organization

Contact information

Practice address
175 CARNEGIE PL STE 109, FAYETTEVILLE, GA 30214-7903
(770) 716-6012
(770) 716-6013
Mailing address
175 CARNEGIE PL STE 109, FAYETTEVILLE, GA 30214-7903
(770) 716-6012
(770) 716-6013

Taxonomy

Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
PSY002374
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000857095B
GA
Enumeration date
07/31/2008
Last updated
07/31/2008
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