Basic Information
| Provider Information | |||||||||
| NPI: | 1528331626 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CCBH PSYCHIATRIC HOSPITALISTS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 340 HOSPITAL DRIVE | ||||||||
| Address2: | CCBH PSYCHIATRIC HOSPITALISTS, LLC | ||||||||
| City: | MACON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4787657000 | ||||||||
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| Address1: | 340 HOSPITAL DRIVE | ||||||||
| Address2: | CCBH PSYCHIATRIC HOSPITALISTS, LLC | ||||||||
| City: | MACON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 31217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4787657000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2012 | ||||||||
| LastUpdateDate: | 02/21/2012 | ||||||||
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| AuthorizedOfficialLastName: | EYLER | ||||||||
| AuthorizedOfficialFirstName: | JIM | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 4787657000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | AUTHORIZED OFFICIAL | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.