Phoenix Behavioral Ealth Services of Georgia

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PHOENIX BEHAVIORAL EALTH SERVICES OF GEORGIA

Practice address

8712 Tara Blvd
Jonesboro, GA 30236-4905

Phone

(770) 478-3417

Fax

(770) 478-3419

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Angela Murrah

Title

Ceo

Phone

(770) 478-3417

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Phoenix Behavioral Ealth Services of Georgia2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Phoenix Behavioral Health Service of Georgia

  • Community/Behavioral Health Agency
  • Jonesboro, GA
  • NPI 1629264627
  NPD tax ID

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189036800000",
    "number": "1376600163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8712 TARA BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302364905",
            "telephone_number": "770-478-3417",
            "fax_number": "770-478-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8712 TARA BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302364905",
            "telephone_number": "770-478-3417",
            "fax_number": "770-478-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX BEHAVIORAL EALTH SERVICES OF GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-09-06",
        "status": "A",
        "authorized_official_last_name": "MURRAH",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-478-3417"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10037340",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137152",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian Pham
• Carol Yvonne Philadelphia, OT
• Melissa Philippe
• Amaria B Phillips, MSW
• Bonnie K. Phillips, D.C.
• Phoenix Behavioral Health Service of Georgia
• Phoenix Behavioral Health Services of Georgia, LLC
• Wasana J Phouangmalay, CST, CSFA
• Physiotherapy Associates Inc
• Luis Enrique Pierantoni Muniz, DC

• Community/Behavioral Health Agency in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.