BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA (NPI# 1083787394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083787394 |
| Entity Type | Organization |
| Organization Name | BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA |
| Other Organization Name | COOK OUTPATIENT SERVICES |
| Practice Address |
1905 S Hutchinson Ave Adel GA 31620-5246 |
| Mailing Address |
3120 N Oak Street Ext Ste C Valdosta GA 31602-5910 |
| Practice Telephone | 2298964559 |
| Practice Fax Number | 2298968367 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2020-03-30 |
| Authorized Official Name | MR. WILLIAM F. HULING (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2296716140 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000601246A | 05 |
| Other Name | Type Code |
|---|---|
| Cook Outpatient Services | Doing Business As Name - Organization |
| Legacy Behavioral Health Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831671973 | Behavioral Health Services of South Georgia | Clinic/Center | 201 W Mcpherson Ave, Nashville, GA 31639-2131 | 2018-09-05 |
| 1528132321 | Behavioral Health Services of South Georgia | Community Based Residential Treatment Facility, Mental Illness | 1 Dellwood Cir, Valdosta, GA 31602-2335 | 2006-11-20 |
| 1083787287 | Behavioral Health Services of South Georgia | Clinic/Center | 507 Laurel St, Nashville, GA 31639-2555 | 2006-11-16 |
| 1912986282 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext, Suite C, Valdosta, GA 31602-1007 | 2006-01-13 |
| 1255875910 | Behavioral Health Services of South Georgia | Community/Behavioral Health | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2016-12-14 |
| 1083754535 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext Ste C, Valdosta, GA 31602-5910 | 2007-02-07 |
| 1639219181 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext Ste C, Valdosta, GA 31602-5910 | 2007-02-07 |
| 1881734333 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext, Valdosta, GA 31602-1007 | 2007-02-07 |
| 1801932371 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext, Suite C, Valdosta, GA 31602-1007 | 2007-01-30 |
| 1588739601 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2006-11-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BEHAVIORAL HEALTH SERVICES OF SOUTH GEORGIA | 3120 N Oak Street Ext Ste C, Valdosta, GA 31602-5910 |
| Street Address |
1905 S HUTCHINSON AVE |
| City | ADEL |
| State | GA |
| Zip Code | 31620-5246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982790929 | Amanda Diane Hall | Social Worker | 1905 S Hutchinson Ave, Adel, GA 31620-5246 | 2006-10-05 |
| 1720632698 | Robin Denise Macon | Social Worker | 1905 S Hutchinson Ave, Adel, GA 31620-5246 | 2019-07-30 |
| 1528530656 | Cleona Marie Griffin | Social Worker | 1905 S Hutchinson Ave, Adel, GA 31620-5246 | 2018-12-31 |
| 1215475470 | Monica Lynn Stalvey | Counselor | 1905 S Hutchinson Ave, Adel, GA 31620-5246 | 2017-02-08 |
| 1245670652 | Georgia Pines Community Service Board | Community/Behavioral Health | 1905 S Hutchinson Ave, Adel, GA 31620-5246 | 2013-06-29 |
| 1154620524 | Margaret O'berry | Registered Nurse | 1905 S Hutchinson Ave, Adel, GA 31620-5246 | 2011-03-24 |
| 1629140512 | Joyce W Johnson | Social Worker | 1905 S Hutchinson Ave, Adel, GA 31620-5246 | 2006-11-15 |
| 1053494138 | Caryl Lynn Gulley | Social Worker | 1905 S Hutchinson Ave, Adel, GA 31620-5246 | 2006-10-23 |
| 1285723684 | Amanda Hope Tillman | Marriage & Family Therapist | 1905 S Hutchinson Ave, Adel, GA 31620-5246 | 2006-10-12 |
| 1598853269 | Markescia Batrice Corker | Social Worker | 1905 S Hutchinson Ave, Adel, GA 31620-5246 | 2006-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588024970 | Wal-mart Store East, Lp | Technician/Technologist | 351 Alabama Road, Adel, GA 31620 | 2016-02-29 |
| 1144699141 | Alexander Warren | Nurse Practitioner | 110 S Hutchinson Ave, Adel, GA 31620 | 2015-09-20 |
| 1538474002 | Tift Regional Health System, Inc. | Specialist | 103 East James Street, Adel, GA 31620 | 2010-08-09 |
| 1427388578 | Newhaven | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 615 South Hutchinson Avenue, Adel, GA 31620 | 2010-01-12 |
| 1942374350 | South Georgia Csb | Clinic/Center | 203 Industrial Park Drive, Adel, GA 31620 | 2006-11-17 |
| 1457424616 | Cook County Board of Education | Local Education Agency (LEA) | 1109 N Parrish Ave, Adel, GA 31620 | 2006-11-16 |
| 1366513210 | Thomas D Fausett Jr. | Family Medicine | 707 N Parrish Ave, Adel, GA 31620 | 2006-11-13 |
| 1689765851 | Chris T. Hilliard | Dentist | 130 S. Parrish Ave., Adel, GA 31620 | 2006-09-27 |
| 1245247303 | Mark A Clegg | Dentist | 606 N Hutchinson Ave, Adel, GA 31620 | 2006-08-02 |
| 1336102938 | Dca of Adel LLC | Clinic/Center | 701 North Hutchinson Avenue, Adel, GA 31620 | 2006-04-07 |
| Find all providers in zip 31620 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245670652 | Georgia Pines Community Service Board | Community/Behavioral Health | 1905 S Hutchinson Ave, Adel, GA 31620-5246 | 2013-06-29 |
| 1316293624 | Xist LLC | Community/Behavioral Health | 705 Main St, Adel, IA 50003-1523 | 2012-07-24 |
| 1013067800 | Dallas County Care Facility Inc | Community/Behavioral Health | 25747 N Ave, Adel, IA 50003-8277 | 2007-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376160 | Love, Breanna Olivia Zion Enterprise,llc(lboz): | Community/Behavioral Health | 9802 N Ivy Park Dr, Fortson, GA 31808-7130 | 2020-11-02 |
| 1578170882 | Helping Hearts Behavioral Health Services, LLC | Community/Behavioral Health | 504 Hamlet Dr, Hampton, GA 30228-4829 | 2020-09-30 |
| 1982219523 | Future Seekers, Inc. | Community/Behavioral Health | 3475 N. Desert Drive, Building 1, Suite 2100, East Point, GA 30344-3034 | 2020-09-10 |
| 1396359840 | Just Like Family Caregivers | Community/Behavioral Health | 2628 Lovejoy Crossing St, Hampton, GA 30228-5995 | 2020-09-02 |
| 1285247270 | Hudu Yoga & Therapy | Community/Behavioral Health | 3900 Springleaf Ct, Stone Mountain, GA 30083-4692 | 2020-08-28 |
| 1952914632 | Brighter Dayz, Incorporated | Community/Behavioral Health | 1016 Howell Mill Rd Nw Apt 4408, Atlanta, GA 30318-5592 | 2020-08-24 |
| 1699387688 | Rise Rehabilitation Services, LLC | Community/Behavioral Health | 738 Highland Park Trl, Atlanta, GA 30350-6706 | 2020-08-20 |
| 1104438373 | Pivotal Counseling LLC | Community/Behavioral Health | 75 N Broad St, Winder, GA 30680-1907 | 2020-08-19 |
| 1295347888 | Freemans Early Intervention Services | Community/Behavioral Health | 13 Peach St, Butler, GA 31006 | 2020-08-17 |
| 1861017634 | Trinity Care Counseling | Community/Behavioral Health | 3475 Northwinds Parkway, 200, Alpharetta, GA 30009 | 2020-06-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.