| Choices For Life Of Georgia, Llc | |
|
2200 N Patterson Street Suite D Valdosta GA 31602-2573 | |
| (229) 244-1707 | |
| (229) 244-1779 |
| Full Name | Choices For Life Of Georgia, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2200 N Patterson Street, Valdosta, Georgia |
| Authorized Official Name and Position | Sara Riley (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2292441707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Choices For Life Of Georgia, Llc 2200 N Patterson Street Suite D Valdosta GA 31602-2573 Ph: (229) 244-1707 | Choices For Life Of Georgia, Llc 2200 N Patterson Street Suite D Valdosta GA 31602-2573 Ph: (229) 244-1707 |
| NPI Number | 1841328960 |
|---|---|
| Provider Enumeration Date | 03/01/2007 |
| Last Update Date | 04/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841328960 | NPI | - | NPPES |
| 001462443A | Medicaid | GA | |
| 631155790A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CPFC001072 (Georgia) | Primary |
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