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TANNER MEDICAL CENTER INC. NPI 1033441290


NPI Information

NPI: 1033441290
Provider Name: TANNER MEDICAL CENTER, INC.

Other Name: TANNER MEDICAL CENTER VILLA RICA BH

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 11D0691309

Address:
101 QUARTZ DR STE 103A
VILLA RICA, GA
ZIP 30180
Phone: (770) 456-3266
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TANNER MEDICAL CENTER, INC. is a community behavioral health in Villa Rica, 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 1033441290. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Tanner Medical Center Villa Rica Bh.

The provider's business location address is:

101 QUARTZ DR STE 103A
VILLA RICA, GA
ZIP 30180-256
Phone: (770) 456-3266

The provider's authorized official is Carol Crews .
The authorized official title is Cfo and has the following contact phone number (770) 836-9745.

The CLIA number assigned to this NPI record is 11D0691309 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 2/12/2010 and was last updated on 5/10/2016.


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 REQUIREDNo
2251S00000XCommunity/Behavioral HealthNOT REQUIREDYes

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
2296667723BMEDICAIDGEORGIA
31871502260OTHERGEORGIAORGANIZATIONAL NPI

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.