| Dba: Annette J Benneche | |
|
110 N Commerce St Hinesville GA 31313-2720 | |
| (912) 332-7503 | |
| (855) 898-5414 |
| Full Name | Dba: Annette J Benneche |
|---|---|
| Speciality | Counselor - Professional |
| Location | 110 N Commerce St, Hinesville, Georgia |
| Authorized Official Name and Position | Annette Benneche (FOUNDER/CEO) |
| Authorized Official Contact | 9123327503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dba: Annette J Benneche 110 N Main St Greensboro GA 30642-1108 Ph: (706) 453-7400 | Dba: Annette J Benneche 110 N Commerce St Hinesville GA 31313-2720 Ph: (912) 332-7503 |
| NPI Number | 1235688250 |
|---|---|
| Provider Enumeration Date | 10/03/2016 |
| Last Update Date | 10/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235688250 | NPI | - | NPPES |
| 10241 | Other | GA | RISK REDUCTION PROGRAM |
| 003129023A | Medicaid | GA | |
| 003129023B | Medicaid | GA | |
| 6546980314546176 | Other | GA | GEORGIA COMMISSION ON FAMILY VIOLENCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 006255 (Georgia) | Primary |
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