NPIMap

Organization Active NPI

River Edge Behavioral Health Center

  • Community/Behavioral Health Agency
  • College Park, GA
National Provider Identifier
1013420496
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
RIVER EDGE BEHAVIORAL HEALTH CENTER
Practice address
5600 Stonewall Tell Rd
College Park, GA 30349-2418
Phone
(478) 803-7646
Fax
(478) 803-8598
NPI assigned
Nov 8, 2017
Last updated
Nov 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miranda Herrington-Nunez
Title
Chief Clinical Officer
Phone
(478) 803-7758

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X NU Primary

Addresses

Primary practice location

5600 Stonewall Tell Rd
College Park, GA 30349-2418

Mailing address

175 Emery Hwy
Macon, GA 31217-3692
Phone (478) 803-7700

National Provider Directory

National Provider Directory
Tax ID family
River Edge Recovery Center Pharmacy77 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

Locations

5600 Stonewall Tell Rd
College Park, GA 30349
Phone (404) 616-4787

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510099200000",
    "number": "1013420496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 EMERY HWY",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312173692",
            "telephone_number": "478-803-7700",
            "fax_number": "478-803-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 STONEWALL TELL RD",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303492418",
            "telephone_number": "478-803-7646",
            "fax_number": "478-803-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER EDGE BEHAVIORAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-08",
        "last_updated": "2017-11-08",
        "status": "A",
        "authorized_official_last_name": "HERRINGTON-NUNEZ",
        "authorized_official_first_name": "MIRANDA",
        "authorized_official_title_or_position": "CHIEF CLINICAL OFFICER",
        "authorized_official_telephone_number": "478-803-7758"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.