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163 E Tollison St Baxley GA 31513-0120 | |
(912) 367-9841 | |
(912) 367-1272 |
Full Name | |
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Speciality | Psychiatric Unit |
Location | 163 E Tollison St, Baxley, Georgia |
Authorized Official Name and Position | Andrea Pierce (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 9123679841 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 2070 Baxley GA 31515-2070 Ph: (912) 367-9841 | 163 E Tollison St Baxley GA 31513-0120 Ph: (912) 367-9841 |
NPI Number | 1104828623 |
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Provider Enumeration Date | 08/15/2005 |
Last Update Date | 03/07/2023 |
Certification Date | 03/07/2023 |
Medicare PECOS PAC ID | 8426957325 |
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Medicare Enrollment ID | O20080812000853 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104828623 | NPI | - | NPPES |
00000052A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
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273R00000X | Psychiatric Unit | 273R00000X (Georgia) | Primary |
Appling Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 755 S Main St, Baxley, GA 31513 Phone: 912-367-4614 Fax: 912-367-9048 | |
Stepping Stones Therapeutic Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 N Thomas St, Baxley, GA 31513 Phone: 912-278-0551 Fax: 912-208-4100 | |