Provider Demographics
NPI:1639413362
Name:CEDAR TREE BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:CEDAR TREE BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:MILFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-442-5929
Mailing Address - Street 1:5588 REYNOLDS RD
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30260-3776
Mailing Address - Country:US
Mailing Address - Phone:706-442-5929
Mailing Address - Fax:
Practice Address - Street 1:5588 REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:GA
Practice Address - Zip Code:30260-3776
Practice Address - Country:US
Practice Address - Phone:706-442-5929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty