Provider Demographics
NPI:1982216438
Name:GA EXCEL BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:GA EXCEL BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CANDACE
Authorized Official - Middle Name:
Authorized Official - Last Name:BYNUM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:404-903-2570
Mailing Address - Street 1:PO BOX 561
Mailing Address - Street 2:
Mailing Address - City:AVONDALE ESTATES
Mailing Address - State:GA
Mailing Address - Zip Code:30002-0561
Mailing Address - Country:US
Mailing Address - Phone:470-396-1998
Mailing Address - Fax:470-396-1998
Practice Address - Street 1:3013 RAINBOW DR STE 124
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-1644
Practice Address - Country:US
Practice Address - Phone:470-396-1998
Practice Address - Fax:470-300-8008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health