Organization
KENNESTONE HOSPTIAL, INC.
Active
Other names
WellStar Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY L SIMONE MD (PRESIDENT & CEO)
(770) 792-7600
Entity
Organization
Contact information
Practice address
3950 AUSTELL RD, WELLSTAR BEHAVIORAL HEALTH CENTER, AUSTELL, GA 30106-1121
(770) 732-6570
(770) 732-6549
Mailing address
2000 S PARK PL SE, WINDY HILL EXCHANGE BUILDING, ATLANTA, GA 30339-2013
(770) 956-6464
(770) 956-6463
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
033-432
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00001999A
—
GA
Enumeration date
02/01/2006
Last updated
02/24/2020
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