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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