Eagle Ranch, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

EAGLE RANCH, INC.

Practice address

5500 Union Church Rd
Flowery Branch, GA 30542-5216

Phone

(770) 967-8500

NPI assigned

May 9, 2022

Last updated

May 9, 2022By 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

Steven Watts, CPA

Title

Cfo

Phone

(770) 967-8500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652054400000",
    "number": "1922744374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7200",
            "city": "CHESTNUT MOUNTAIN",
            "state": "GA",
            "postal_code": "305020050",
            "telephone_number": "770-967-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 UNION CHURCH RD",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305425216",
            "telephone_number": "770-967-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE RANCH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-09",
        "last_updated": "2022-05-09",
        "certification_date": "2022-04-22",
        "status": "A",
        "authorized_official_last_name": "WATTS",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-967-8500",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Flowery Branch, GA
• Providers in Flowery Branch, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2022; 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.