TARA PETTIT DELOACH LLC NPI 1124897145

NPI Information

NPI: 1124897145
Provider Name: TARA PETTIT DELOACH LLC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
930 STEVENS CREEK RD
AUGUSTA, GA
ZIP 30907
Phone: (706) 343-3661
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TARA PETTIT DELOACH LLC is an adult mental health clinic center in Augusta, GA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. TARA PETTIT DELOACH LLC NPI is 1124897145. The provider is registered as an organization entity type.

The provider's business location address is:

930 STEVENS CREEK RD
AUGUSTA, GA
ZIP 30907-200
Phone: (706) 343-3661

The provider's authorized official is Tara Pettit Deloach .
The authorized official title is Owner and has the following contact phone number (706) 343-3661.

The enumeration date for this NPI number is 1/2/2024 and was last updated on 1/2/2024.

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
1	261QM0850X	Clinic/Center	Adult Mental Health			Yes

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

NPI Synchronization or Removal

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