Provider Demographics
NPI:1104319854
Name:GOAL POINT BEHAVIOR GROUP LLC
Entity type:Organization
Organization Name:GOAL POINT BEHAVIOR GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-REGIONAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:678-788-3328
Mailing Address - Street 1:107 INDEPENDENCE DR STE D
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-7814
Mailing Address - Country:US
Mailing Address - Phone:478-333-5024
Mailing Address - Fax:706-243-6497
Practice Address - Street 1:644 TALLULAH TRL
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-7625
Practice Address - Country:US
Practice Address - Phone:478-225-2179
Practice Address - Fax:706-243-6497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-07
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-17-26263103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003200275AMedicaid
GA003204013AMedicaid