Provider Demographics
NPI:1295483253
Name:ARKWRIGHT SHOALS BEHAVIORAL HEALTH INCORPORATED
Entity type:Organization
Organization Name:ARKWRIGHT SHOALS BEHAVIORAL HEALTH INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:W
Authorized Official - Last Name:BYRAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:478-251-5711
Mailing Address - Street 1:15384 US HIGHWAY 441
Mailing Address - Street 2:
Mailing Address - City:MC INTYRE
Mailing Address - State:GA
Mailing Address - Zip Code:31054-2283
Mailing Address - Country:US
Mailing Address - Phone:478-239-5924
Mailing Address - Fax:478-253-5943
Practice Address - Street 1:15384 US HIGHWAY 441
Practice Address - Street 2:
Practice Address - City:MC INTYRE
Practice Address - State:GA
Practice Address - Zip Code:31054-2283
Practice Address - Country:US
Practice Address - Phone:478-239-5924
Practice Address - Fax:478-253-5943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-17
Last Update Date:2022-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty