Provider Demographics
NPI:1477014413
Name:PROFESSIONAL BEHAVIORAL HEALTH AND ASSOCIATES, LLC
Entity Type:Organization
Organization Name:PROFESSIONAL BEHAVIORAL HEALTH AND ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:TURLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-284-1008
Mailing Address - Street 1:245 COUNTRY CLUB DR BLDG 300B
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-7213
Mailing Address - Country:US
Mailing Address - Phone:678-284-1008
Mailing Address - Fax:678-284-1009
Practice Address - Street 1:245 COUNTRY CLUB DR BLDG 300B
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-7213
Practice Address - Country:US
Practice Address - Phone:678-284-1008
Practice Address - Fax:678-284-1009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-30
Last Update Date:2019-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty