| |
415 Ernest Biles Dr Jackson GA 30233-2282 | |
(770) 775-5129 | |
Not Available |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 415 Ernest Biles Dr, Jackson, Georgia |
Authorized Official Name and Position | Pamela Mccollum (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 7703588251 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1501a Kalamazoo Dr Po Box 1320 Griffin GA 30224-3919 Ph: (770) 358-8250 | 415 Ernest Biles Dr Jackson GA 30233-2282 Ph: (770) 775-5129 |
NPI Number | 1194993030 |
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Provider Enumeration Date | 02/13/2008 |
Last Update Date | 02/13/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194993030 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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