NPIMap

Organization Active NPI

River Edge Behavioral Health Center

  • Community/Behavioral Health Agency
  • Forsyth, GA
National Provider Identifier
1477612810
Registry record updated Jan 30, 2019
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
168 Old Brent Rd
Forsyth, GA 31029-6911
Phone
(478) 803-7602
NPI assigned
Dec 8, 2006
Last updated
Jan 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

168 Old Brent Rd
Forsyth, GA 31029-6911

Mailing address

168 Old Brent Rd
Forsyth, GA 31029-6911
Phone (478) 803-7602

Other identifiers 1

IdentifierTypeStateIssuer
000604194UMedicaidGA

Other names 1

  • Old Brent Road Other name

National Provider Directory

National Provider Directory
Tax ID family
River Edge Behavorial H77 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

168 Old Brent Rd
Forsyth, GA 31029
Phone (478) 751-4507

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548806400000",
    "number": "1477612810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 OLD BRENT RD",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310296911",
            "telephone_number": "478-803-7602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "168 OLD BRENT RD",
            "city": "FORSYTH",
            "state": "GA",
            "postal_code": "310296911",
            "telephone_number": "478-803-7602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER EDGE BEHAVIORAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2019-01-30",
        "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": "000604194U",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Old Brent Road",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Old Brent Road",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Forsyth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; 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.