| Black Crow Behavioral | |
|
611 E Church St Jasper GA 30143-1313 | |
| (404) 737-2299 | |
| (404) 912-9184 |
| Full Name | Black Crow Behavioral |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 611 E Church St, Jasper, Georgia |
| Authorized Official Name and Position | Julie Deloach Everett (OWNER) |
| Authorized Official Contact | 4047372299 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Crow Behavioral 611 E Church St Jasper GA 30143-1313 Ph: (404) 737-2299 | Black Crow Behavioral 611 E Church St Jasper GA 30143-1313 Ph: (404) 737-2299 |
| NPI Number | 1245100940 |
|---|---|
| Provider Enumeration Date | 11/07/2025 |
| Last Update Date | 11/07/2025 |
| Certification Date | 11/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245100940 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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