Organization
GEORGIA BEHAVIORAL CAMPUS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER BLACKLOCK (DIRECTOR OF FINANCE)
(678) 769-6594
Entity
Organization
Contact information
Practice address
211 GOOSE HOLLOW RD BLDG I, REYNOLDS, GA 31076-3505
(678) 769-6594
Mailing address
211 GOOSE HOLLOW RD BLDG I, REYNOLDS, GA 31076-3505
(678) 769-6594
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/20/2024
Last updated
03/20/2024
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