| Friends Of Coastal Ga Llc | |
|
528 Golden Grove Ln Richmond Hill GA 31324-5908 | |
| (888) 508-1012 | |
| (888) 558-9897 |
| Full Name | Friends Of Coastal Ga Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 528 Golden Grove Ln, Richmond Hill, Georgia |
| Authorized Official Name and Position | Maranda Leah Porter (OWNER BEHAVIOR ANALYST) |
| Authorized Official Contact | 8885081012 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Friends Of Coastal Ga Llc 528 Golden Grove Ln Richmond Hill GA 31324-5908 Ph: (888) 508-1012 | Friends Of Coastal Ga Llc 528 Golden Grove Ln Richmond Hill GA 31324-5908 Ph: (888) 508-1012 |
| NPI Number | 1922743848 |
|---|---|
| Provider Enumeration Date | 05/04/2022 |
| Last Update Date | 05/04/2022 |
| Certification Date | 05/04/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922743848 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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