Provider Demographics
NPI:1497314900
Name:RAYMIR BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:RAYMIR BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN OF THE BOARD
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:POLYNICE
Authorized Official - Suffix:
Authorized Official - Credentials:MT
Authorized Official - Phone:678-468-8891
Mailing Address - Street 1:2899 H D ATHA RD
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-0728
Mailing Address - Country:US
Mailing Address - Phone:678-468-9295
Mailing Address - Fax:770-728-4388
Practice Address - Street 1:2899 H D ATHA RD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-0728
Practice Address - Country:US
Practice Address - Phone:678-468-9295
Practice Address - Fax:770-728-4388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-08
Last Update Date:2019-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health