| |
760 S Main St #a Hinesville GA 31313-4613 | |
(912) 554-8510 | |
(912) 264-5965 |
Full Name | |
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Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
Location | 760 S Main St, Hinesville, Georgia |
Authorized Official Name and Position | Rachel N. Skinner (DIRECTOR OF REIMBURSEMENT) |
Authorized Official Contact | 9125548498 |
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) 554-8510 | 760 S Main St #a Hinesville GA 31313-4613 Ph: (912) 554-8510 |
NPI Number | 1700915931 |
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Provider Enumeration Date | 03/05/2007 |
Last Update Date | 01/05/2012 |
Identifier | Type | State | Issuer |
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1700915931 | NPI | - | NPPES |
000859141B | Medicaid | GA | |
000622553AM | Medicaid | GA |
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