Organization
PEACHSTATE PSYCHIATRIC SERVICES, INC.
Active
Organization
PEACHSTATE PSYCHIATRIC SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT A. OWENS M.D. (OWNER)
(404) 575-4785
Entity
Organization
Contact information
Practice address
1720 PEACHTREE ST NW STE 640, ATLANTA, GA 30309-2450
(404) 575-4785
Mailing address
1720 PEACHTREE ST NW STE 640, ATLANTA, GA 30309-2450
(404) 575-4785
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
Primary
080408LGB
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000851309A
MEDICAID GBH
—
01
—
102379467
UBH/EVERCARE
—
01
—
158479400
OWCP
—
01
—
162363
VALUE OPTIONS
—
01
—
26BDHBD
WELLCARE MEDICARE
—
01
—
27868800
WELLCRE MEDICAID
—
01
—
278688000
MAGELLAN PERSONAL
—
01
—
52806851
BC/BS GEORGIA
GA
01
—
52806851
BC/BS PLAN LOCATOR
—
01
—
713313717
AMERIGROUP
—
01
—
7698253
AETNA
GA
01
—
80440600
MAGELLAN GROUP
GA
05
—
CLARENCE5
—
GA
Enumeration date
08/13/2009
Last updated
08/13/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up