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TANNER MEDICAL CENTER INC NPI 1871502260


NPI Information

NPI: 1871502260
Provider Name: TANNER MEDICAL CENTER, INC

Other Name: TANNER MEDICAL CENTER CARROLLTON BH

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
523 DIXIE ST
CARROLLTON, GA
ZIP 30117
Phone: (770) 836-9697
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TANNER MEDICAL CENTER, INC is a community behavioral health in Carrollton, GA. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, 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. TANNER MEDICAL CENTER, INC NPI is 1871502260. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Tanner Medical Center Carrollton Bh.

The provider's business location address is:

523 DIXIE ST
CARROLLTON, GA
ZIP 30117-870
Phone: (770) 836-9697
Fax: (770) 836-9897

The provider's authorized official is Lee C. Sherseth .
The authorized official title is Cfo and has the following contact phone number (770) 836-9697.

The enumeration date for this NPI number is 8/5/2006 and was last updated on 2/18/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101Y00000XCounselorNOT REQUIREDGEORGIANo
2251S00000XCommunity/Behavioral Health022-426GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1300027104AOTHERGEORGIAMEDICAID PAYEE IDENTIFICATION NUMBER
2296667723AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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