Devereux Georgia Treatment Network

LBN: Devereux Foundation
Devereux Georgia Treatment Network is an health care organization with primary practice located at 1291 Stanley Rd Nw , Kennesaw GA 30152-4359. The organization recently has only one registered license in Residential Treatment Facilities / Psychiatric Residential Treatment Facility, which is considered as the primary health care specialty. Devereux Foundation can be contacted via phone (770) 427-0147, or through Bolivar, Mario via phone (687) 303-2669.

Contact Information

Primary practice address
1291 Stanley Rd Nw Kennesaw GA 30152-4359
Phone: (770) 427-0147
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Bolivar, Mario
Phone: (687) 303-2669

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Psychiatric Residential Treatment Facility 323P00000X 5910 Georgia

Profile Details

NPI number 1346319142
LBN Legal business name Devereux Foundation
DBA Doing business as Devereux Georgia Treatment Network
Authorized official Bolivar, Mario
Entity Organization
Organization subpart 1 No
Enumeration date Nov 7th, 2006
Last updated Jan 16th, 2009 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346319142 NPPES
Georgia MEDICAID 087592297A
Georgia MEDICAID 3404521
Georgia MEDICAID 700401000
Georgia MEDICAID 0002464004

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