Organization
WILLOW OAK COMMUNITY BEHAVIORAL HEALTH CENTER, INC.
Active
Organization
WILLOW OAK COMMUNITY BEHAVIORAL HEALTH CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE BOULAI (CEO)
(678) 477-3476
Entity
Organization
Contact information
Practice address
6944 HIGHWAY 85 STE F, RIVERDALE, GA 30274-2960
(770) 683-6946
(779) 683-6949
Mailing address
361 CLIFFHAVEN CIR, NEWNAN, GA 30263-6358
(678) 477-3476
(770) 683-6949
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
02/23/2022
Last updated
02/12/2024
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