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Organization

TMC WEST GEORGIA BEHAVIORAL HEALTH INC

Active
Other names
West Georgia Behavioral Health
Organization subpart
No

Provider details

NPI number
Authorized official
DEBBI MACALUSO-PEARE (CHIEF FINANCIAL OFFICER)
(770) 838-8554
Entity
Organization

Contact information

Practice address
101 QUARTZ DR, SUITE 103, VILLA RICA, GA 30180-3255
(770) 456-3722
(770) 456-3739
Mailing address
101 QUARTZ DR, SUITE 103, VILLA RICA, GA 30180-3255
(770) 456-3722
(770) 456-3739

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
035853
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
DA2102
MEDICARE ID
GA
Enumeration date
07/30/2006
Last updated
05/18/2009
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