Re-Direct Behavioral Youth Program

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

RE-DIRECT BEHAVIORAL YOUTH PROGRAM

Practice address

900 MLK Jr Dr
Dublin, GA 31021-5063

Phone

(478) 304-1403

NPI assigned

Aug 5, 2019

Organization subpart

No

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

Authorized official

Name

Joe Nathan Ricks, ETC.

Title

Ceo

Phone

(478) 697-5304

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1564963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564963200000",
    "number": "1558916726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16355",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310406355",
            "telephone_number": "478-697-5304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MLK JR DR",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310215063",
            "telephone_number": "478-304-1403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RE-DIRECT BEHAVIORAL YOUTH PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-05",
        "last_updated": "2019-08-05",
        "status": "A",
        "authorized_official_last_name": "RICKS",
        "authorized_official_first_name": "JOE",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-697-5304",
        "authorized_official_credential": "ETC."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "joe.ricks@redirectbyp.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "900 Mlk Jr Dr",
            "city": "Dublin",
            "state": "GA",
            "country_code": "US",
            "postal_code": "310215063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erich Graham Randolph, MD
• Taveyus Shudon Randolph
• Jafar Rashed
• Kenia Mashet Rawles, LMSW
• Floyd Douglas Raynor, LCSW
• Francis Carroll Reese, M.D.
• Denise Register
• Rehab Advantage and Sports Medicine, Inc
• Rejoice Home Care
• Restored Wellness, LLC

• Case Management Agency in Dublin, GA
• Providers in Dublin, GA by specialty
• Case Management Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.