| Gateway Bhs - Pembroke Adult Outpatient | |
|
40 E Industrial Blvd Pembroke GA 31321 | |
| (912) 653-4151 | |
| (912) 653-2886 |
| Full Name | Gateway Bhs - Pembroke Adult Outpatient |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 40 E Industrial Blvd, Pembroke, Georgia |
| Authorized Official Name and Position | Wendy Hughes (CFO) |
| Authorized Official Contact | 9125448510 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Bhs - Pembroke Adult Outpatient 700 Coastal Village Dr Brunswick GA 31520-1974 Ph: (912) 264-0979 | Gateway Bhs - Pembroke Adult Outpatient 40 E Industrial Blvd Pembroke GA 31321 Ph: (912) 653-4151 |
| NPI Number | 1184753709 |
|---|---|
| Provider Enumeration Date | 03/02/2007 |
| Last Update Date | 10/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184753709 | NPI | - | NPPES |
| 000606339Z | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
4fun, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 23439 Ga Highway 46, Pembroke, GA 31321 Phone: 912-823-3183 |