Organization
HEPHZIBAH BEHAVIORAL HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER BAGLEY (PRESIDENT AND CEO)
(478) 476-0805
Entity
Organization
Contact information
Practice address
1902 FORSYTH ST STE D, MACON, GA 31201-8132
(478) 476-0805
(478) 475-9492
Mailing address
1902 FORSYTH ST STE D, MACON, GA 31201-8132
(478) 476-0805
(478) 475-9492
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
585571168A
—
GA
Enumeration date
07/26/2007
Last updated
09/27/2018
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