NPIMap

Organization Active NPI

Advantage Behavioral Health Systems

  • Developmental Disabilities Clinic/Center
  • Madison, GA
National Provider Identifier
1215420690
Registry record updated Jun 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
ADVANTAGE BEHAVIORAL HEALTH SYSTEMS
Practice address
1801 Prospect Rd.
Madison, GA 30650
Phone
(706) 389-6789
Fax
(706) 389-6768
NPI assigned
Jun 11, 2018
Last updated
Jun 11, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
ADVANTAGE BEHAVIORAL HEALTH SYSTEMSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2018

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

Authorized official

Name
Mr. Oliver J Booker
Title
Ceo
Phone
(706) 389-6789

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X GA Primary

Addresses

Primary practice location

1801 Prospect Rd.
Madison, GA 30650

Mailing address

250 North Ave
Athens, GA 30601-2244
Phone (706) 389-6789

Other identifiers 1

IdentifierTypeStateIssuer
000631562FKMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
True Comfort Care Home 659 organizations share this tax ID, including this one
Part of
True Comfort Care Home 6

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

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528675200000",
    "number": "1215420690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 NORTH AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306012244",
            "telephone_number": "706-389-6789",
            "fax_number": "706-227-7249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 PROSPECT RD.",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "30650",
            "telephone_number": "706-389-6789",
            "fax_number": "706-389-6768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE BEHAVIORAL HEALTH SYSTEMS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANTAGE BEHAVIORAL HEALTH SYSTEMS",
        "enumeration_date": "2018-06-11",
        "last_updated": "2018-06-11",
        "status": "A",
        "authorized_official_last_name": "BOOKER",
        "authorized_official_first_name": "OLIVER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-389-6789",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000631562FK",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.