Organization
RIVER EDGE BEHAVIORAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANNA HIERS ALEXANDER (BILLING MANAGER)
(478) 751-4507
Entity
Organization
Contact information
Practice address
109 E MAIN ST, JEFFERSONVILLE, GA 31044-9426
(478) 751-4519
Mailing address
175 EMERY HWY, MACON, GA 31217-3692
(478) 751-4507
(478) 751-4536
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000604194AM
—
GA
Enumeration date
03/10/2009
Last updated
03/10/2009
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