Provider Demographics
NPI:1720634884
Name:IRIE'S BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:IRIE'S BEHAVIORAL HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOWNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:470-357-2562
Mailing Address - Street 1:5495 OLD NATIONAL HWY STE C1
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-3256
Mailing Address - Country:US
Mailing Address - Phone:470-357-2561
Mailing Address - Fax:
Practice Address - Street 1:5495 OLD NATIONAL HWY STE C1
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-3256
Practice Address - Country:US
Practice Address - Phone:470-357-2561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IRIE'S COMMUNITY DEVELOPMENT CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty