Integrated Behavioral Center Pc | |
1121 Cornell Avenue Savannah GA 31406 | |
(912) 355-4987 | |
(912) 353-7257 |
Full Name | Integrated Behavioral Center Pc |
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Speciality | Psychiatry & Neurology |
Location | 1121 Cornell Avenue, Savannah, Georgia |
Authorized Official Name and Position | Manoj K Dass (PRESIDENT) |
Authorized Official Contact | 9123554987 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Integrated Behavioral Center Pc 1121 Cornell Avenue Savannah GA 31406 Ph: (912) 355-4987 | Integrated Behavioral Center Pc 1121 Cornell Avenue Savannah GA 31406 Ph: (912) 355-4987 |
NPI Number | 1649201625 |
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Provider Enumeration Date | 07/06/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 0840364931 |
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Medicare Enrollment ID | O20080807000461 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649201625 | NPI | - | NPPES |
00235034A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
104100000X | Social Worker | 002990 (Georgia) | Primary |
2084P0800X | Psychiatry & Neurology - Psychiatry | 22536 (Georgia) | Primary |
Provider Name | Kavinder Sahota |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1407914609 PECOS PAC ID: 2769492412 Enrollment ID: I20060426000399 |
Provider Name | Manoj K Dass |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1831227487 PECOS PAC ID: 0941374037 Enrollment ID: I20080807000453 |
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