Provider Demographics
NPI:1649097643
Name:INTEGRITY BEHAVIOR HEALTH OUTPATIENT CENTER
Entity type:Organization
Organization Name:INTEGRITY BEHAVIOR HEALTH OUTPATIENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:LASHON
Authorized Official - Last Name:RANSOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-755-7160
Mailing Address - Street 1:194 JONESBORO RD STE K6
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-4818
Mailing Address - Country:US
Mailing Address - Phone:770-629-2167
Mailing Address - Fax:
Practice Address - Street 1:194 JONESBORO RD STE K6
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-4818
Practice Address - Country:US
Practice Address - Phone:770-629-2167
Practice Address - Fax:470-758-8853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty