Saint Lazarus Behavioral Health Inc.

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

056360 Issued in GA

Legal business name

SAINT LAZARUS BEHAVIORAL HEALTH INC.

Practice address

4905 Forsyth Rd
Macon, GA 31210-4401

Phone

(865) 765-8224

Fax

(478) 474-6585

NPI assigned

Jul 15, 2009

Last updated

Jul 15, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Inimbom Samuel, MDNPI 1992833099

Title

President

Phone

(865) 765-8224

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Samuel I Samuel, MD

  • Psychiatry Physician
  • Salinas, CA
  • NPI 1992833099
  Authorized official Same address or phone
• Nellie Idara Samuel, MSN, APRN,PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Macon, GA
  • NPI 1821344557
  NPD (past)

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

{
    "created_epoch": "1247616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247616000000",
    "number": "1780814574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 PROVIDENCE BLVD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312107565",
            "telephone_number": "865-765-8224",
            "fax_number": "478-474-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 FORSYTH RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104401",
            "telephone_number": "865-765-8224",
            "fax_number": "478-474-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT LAZARUS BEHAVIORAL HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-07-15",
        "status": "A",
        "authorized_official_last_name": "SAMUEL",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "INIMBOM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-765-8224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "GA",
            "license": "056360",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "GA",
            "license": "056360",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "712889273A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hakan Alp Sahinoglu, DO
• Sai Rehab Inc
• Tina Saiani, FNP-C
• Janet Said, LMFT
• Smera Saikumar, DO
• Monali V Sakhalkar, MD
• Om Vishwas Sakhalkar
• Vishwas S Sakhalkar, MD
• Dominik Sakowski, MD
• Joshua Joseph Sale

• Adolescent and Children Mental Health Clinic/Center in Macon, GA
• Providers in Macon, GA by specialty
• Adolescent and Children Mental Health Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; 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.