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1113 E Oglethorpe Hwy Hinesville GA 31313-1200 | |
| (912) 368-3502 | |
| (912) 368-6844 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1113 E Oglethorpe Hwy, Hinesville, 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 |
|---|---|
700 Coastal Village Dr Brunswick GA 31520-1974 Ph: (912) 264-0979 | 1113 E Oglethorpe Hwy Hinesville GA 31313-1200 Ph: (912) 368-3502 |
| NPI Number | 1740319359 |
|---|---|
| Provider Enumeration Date | 03/02/2007 |
| Last Update Date | 09/27/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740319359 | NPI | - | NPPES |
| 000714689P | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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