Provider Demographics
NPI:1730963349
Name:BETHEL PSYCHIATRIC SERVICES INC
Entity type:Organization
Organization Name:BETHEL PSYCHIATRIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:OLOLADE
Authorized Official - Middle Name:
Authorized Official - Last Name:BABARINDE
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:404-455-2959
Mailing Address - Street 1:980 BIRMINGHAM RD STE 501294
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:GA
Mailing Address - Zip Code:30004-4417
Mailing Address - Country:US
Mailing Address - Phone:404-455-2959
Mailing Address - Fax:
Practice Address - Street 1:980 BIRMINGHAM RD STE 501294
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:GA
Practice Address - Zip Code:30004-4417
Practice Address - Country:US
Practice Address - Phone:404-455-2959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-23
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)