Provider Demographics
NPI:1982935052
Name:VILLA RICA BEHAVIORAL HEALTH PC
Entity Type:Organization
Organization Name:VILLA RICA BEHAVIORAL HEALTH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:W
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-456-2788
Mailing Address - Street 1:514 W BANKHEAD HWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:VILLA RICA
Mailing Address - State:GA
Mailing Address - Zip Code:30180-1736
Mailing Address - Country:US
Mailing Address - Phone:770-456-2788
Mailing Address - Fax:770-456-2789
Practice Address - Street 1:514 W BANKHEAD HWY
Practice Address - Street 2:SUITE 400
Practice Address - City:VILLA RICA
Practice Address - State:GA
Practice Address - Zip Code:30180-1736
Practice Address - Country:US
Practice Address - Phone:770-456-2788
Practice Address - Fax:770-456-2789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty