Provider Demographics
NPI:1730646019
Name:UNITED BEHAVIORAL HEALTH CENTER LLC.
Entity type:Organization
Organization Name:UNITED BEHAVIORAL HEALTH CENTER LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEVYLLA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANDING
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:910-299-2094
Mailing Address - Street 1:101 BLUE MOON CROSSING SUITE 3
Mailing Address - Street 2:BOX 259
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322
Mailing Address - Country:US
Mailing Address - Phone:910-299-2094
Mailing Address - Fax:
Practice Address - Street 1:59 MELODY DR
Practice Address - Street 2:
Practice Address - City:POOLER
Practice Address - State:GA
Practice Address - Zip Code:31322-3644
Practice Address - Country:US
Practice Address - Phone:910-299-2094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty