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275 First Street Extention Springfield GA 31329 | |
(912) 754-3030 | |
(912) 754-9210 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 275 First Street Extention, Springfield, Georgia |
Authorized Official Name and Position | William Parks (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 9125548464 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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700 Coastal Village Dr Brunswick GA 31520-1974 Ph: (912) 264-0979 | 275 First Street Extention Springfield GA 31329 Ph: (912) 754-3030 |
NPI Number | 1437288669 |
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Provider Enumeration Date | 03/05/2007 |
Last Update Date | 10/15/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1437288669 | NPI | - | NPPES |
000859141F | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |