NPIMap

Organization Active NPI

River Edge Behavioral Health Center

  • Community/Behavioral Health Agency
  • Macon, GA
National Provider Identifier
1124189311
Registry record updated Nov 17, 2009
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
139 Woodfield Dr
Macon, GA 31210-5680
Phone
(478) 751-4519
Fax
(478) 751-4444
NPI assigned
Dec 12, 2006
Last updated
Nov 17, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Authorized official

Name
Mrs. Emily Beth Tyler
Title
Cfo
Phone
(478) 752-3231

Specialties & licenses 1

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

Addresses

Primary practice location

139 Woodfield Dr
Macon, GA 31210-5680

Mailing address

139 Woodfield Dr
Macon, GA 31210-5680
Phone (478) 751-4519

Other identifiers 1

IdentifierTypeStateIssuer
000831036AMedicaidGA

Other names 1

  • Woodfield Other name

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 24

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

View all 24

Locations

139 Woodfield Dr
Macon, GA 31210

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258416000000",
    "number": "1124189311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 WOODFIELD DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105680",
            "telephone_number": "478-751-4519",
            "fax_number": "478-751-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 WOODFIELD DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105680",
            "telephone_number": "478-751-4519",
            "fax_number": "478-751-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER EDGE BEHAVIORAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2009-11-17",
        "status": "A",
        "authorized_official_last_name": "TYLER",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "BETH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "478-752-3231",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000831036A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodfield",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; 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.