Provider Demographics
NPI:1750151767
Name:OVERFLOWING HEALTH BEHAVIORAL LLC
Entity type:Organization
Organization Name:OVERFLOWING HEALTH BEHAVIORAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RIUYINOSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-227-4754
Mailing Address - Street 1:461 3RD ST STE 13
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-3358
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:461 3RD ST STE 13
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-3358
Practice Address - Country:US
Practice Address - Phone:478-227-4754
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-02
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental HealthGroup - Single Specialty