NPIMap

Organization Active NPI

St Mikels Behavioral Health Services LLC

  • Community/Behavioral Health Agency
  • Johns Creek, GA
National Provider Identifier
1083106686
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ST MIKELS BEHAVIORAL HEALTH SERVICES LLC
Doing business as
St Mikels behavioral health services llc
Practice address
11638 Davenport LN
Johns Creek, GA 30005-4610
Phone
(470) 263-8517
NPI assigned
May 31, 2018
Last updated
May 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

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

Authorized official

Name
Morufat Diji
Title
Ceo
Phone
(470) 263-8517

Specialties & licenses 1

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

Addresses

Primary practice location

11638 Davenport LN
Johns Creek, GA 30005-4610

Mailing address

1205 Fiscer Trace
Cumming, GA 30041
Phone (470) 263-8517

Other names 1

  • St Mikels behavioral health services llc Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1083106686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 FISCER TRACE",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30041",
            "telephone_number": "470-263-8517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11638 DAVENPORT LN",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300054610",
            "telephone_number": "470-263-8517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MIKELS BEHAVIORAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "DIJI",
        "authorized_official_first_name": "MORUFAT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "470-263-8517"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Mikels behavioral health services llc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Mikels behavioral health services llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; 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.