First Focus Faith, Llc | |
4145 Columbia Rd Martinez GA 30907-5400 | |
(706) 524-3690 | |
Not Available |
Full Name | First Focus Faith, Llc |
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Speciality | Community/Behavioral Health |
Location | 4145 Columbia Rd, Martinez, Georgia |
Authorized Official Name and Position | Charlesetta Willis (ASSISTANT DIRECTOR) |
Authorized Official Contact | 7065243690 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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First Focus Faith, Llc 860 Willow Lk Evans GA 30809-8000 Ph: (706) 524-3690 | First Focus Faith, Llc 4145 Columbia Rd Martinez GA 30907-5400 Ph: (706) 524-3690 |
NPI Number | 1861130932 |
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Provider Enumeration Date | 05/26/2022 |
Last Update Date | 05/26/2022 |
Certification Date | 05/26/2022 |
Medicare PECOS PAC ID | 6800267345 |
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Medicare Enrollment ID | O20230120001755 |
Identifier | Type | State | Issuer |
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1861130932 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Provider Name | Simone S Davis |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1750047650 PECOS PAC ID: 1557732005 Enrollment ID: I20230120002125 |
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