| Skidaway Behavioral Institute Llc | |
|
3 Westridge Rd Savannah GA 31411-2951 | |
| (912) 372-3700 | |
| Not Available |
| Full Name | Skidaway Behavioral Institute Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3 Westridge Rd, Savannah, Georgia |
| Authorized Official Name and Position | Hamilton Peirsol (FOUNDER/CLINICAL DIRECTOR) |
| Authorized Official Contact | 9123723700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Skidaway Behavioral Institute Llc Po Box 13643 Savannah GA 31416-0643 Ph: (912) 372-3700 | Skidaway Behavioral Institute Llc 3 Westridge Rd Savannah GA 31411-2951 Ph: (912) 372-3700 |
| NPI Number | 1922623644 |
|---|---|
| Provider Enumeration Date | 06/09/2020 |
| Last Update Date | 10/02/2024 |
| Certification Date | 10/02/2024 |
| Medicare PECOS PAC ID | 5294159992 |
|---|---|
| Medicare Enrollment ID | O20200727003461 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922623644 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | John Michael Adler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689786865 PECOS PAC ID: 8820132293 Enrollment ID: I20110210000645 |
| Provider Name | Hamilton Peirsol |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831550565 PECOS PAC ID: 8820412521 Enrollment ID: I20240514001382 |
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