Provider Demographics
NPI:1134648538
Name:GEORGIA BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:GEORGIA BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NEHA
Authorized Official - Middle Name:
Authorized Official - Last Name:KHURANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-861-6463
Mailing Address - Street 1:4220 FALLS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-8489
Mailing Address - Country:US
Mailing Address - Phone:678-861-6463
Mailing Address - Fax:
Practice Address - Street 1:3965 HOLCOMB BRIDGE RD STE 102
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-2203
Practice Address - Country:US
Practice Address - Phone:678-861-6463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-17
Last Update Date:2017-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health