Provider Demographics
NPI:1689393332
Name:MAYSPRINGS BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:MAYSPRINGS BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NDIDIAMAKA
Authorized Official - Middle Name:ONYEANWULI
Authorized Official - Last Name:NWAKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-627-7215
Mailing Address - Street 1:1000 PEACHTREE INDUSTRIAL BLVD STE 6-478
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6737
Mailing Address - Country:US
Mailing Address - Phone:770-627-7215
Mailing Address - Fax:
Practice Address - Street 1:3995 S COBB DR SE
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-6342
Practice Address - Country:US
Practice Address - Phone:770-627-7215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No283Q00000XHospitalsPsychiatric Hospital