| NPI | 1780011841 |
|---|---|
| Doing Business As | PROVIDIAN BEHAVIORAL HEALTH |
| Entity Type | Organization |
| Authorized Contact | ELAINA STELLETTE HALL CEO 678-491-7870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2013-10-03 |