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794 Mcdonough Road Suite #104, Obot Room #100 Jackson GA 30233-1572 | |
(770) 775-9044 | |
(770) 775-9075 |
Full Name | |
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Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
Location | 794 Mcdonough Road, Jackson, Georgia |
Authorized Official Name and Position | Jay Higham (CEO) |
Authorized Official Contact | 2143656112 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5001 Spring Valley Road Suite 600 East Dallas TX 75244-3946 Ph: (214) 365-6100 | 794 Mcdonough Road Suite #104, Obot Room #100 Jackson GA 30233-1572 Ph: (770) 775-9044 |
NPI Number | 1003510520 |
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Provider Enumeration Date | 03/28/2023 |
Last Update Date | 12/18/2024 |
Certification Date | 12/18/2024 |
Identifier | Type | State | Issuer |
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1003510520 | NPI | - | NPPES |
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