Organization
MAGELLAN BEHAVIORAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BOUG BOWES MSW (GENERAL MANAGER)
(678) 319-3799
Entity
Organization
Contact information
Practice address
3970 N INDIAN CIR NW, KENNESAW, GA 30144-5008
(678) 319-3759
(314) 292-1286
Mailing address
3970 N INDIAN CIR NW, KENNESAW, GA 30144-5008
(678) 319-3759
(314) 292-1286
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
RN091291
GA
Other
Enumeration date
02/06/2007
Last updated
08/22/2020
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