NPIMap

Organization Active NPI

River Edge Behavioral Health Center

  • Community/Behavioral Health Agency
  • Gray, GA
National Provider Identifier
1487716577
Registry record updated Aug 22, 2020
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
151 Childs St
Gray, GA 31032-5637
Phone
(478) 751-4507
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

151 Childs St
Gray, GA 31032-5637

Mailing address

151 Childs St
Gray, GA 31032-5637
Phone (478) 751-4507

Other identifiers 1

IdentifierTypeStateIssuer
00604194JMedicaidGA

Other names 1

  • Childs St. Other name

National Provider Directory

National Provider Directory
Tax ID family
Chigorziri D Umuna77 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

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487716577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 CHILDS ST",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310325637",
            "telephone_number": "478-751-4507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 CHILDS ST",
            "city": "GRAY",
            "state": "GA",
            "postal_code": "310325637",
            "telephone_number": "478-751-4507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER EDGE BEHAVIORAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-08-22",
        "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": "00604194J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Childs St.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gray, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.