| Gateway Bhs - Scs Bonaventure C & A Outpatient | |
|
415 Bonaventure Rd Thunderbolt GA 31404-3299 | |
| (912) 790-6527 | |
| (912) 644-7729 |
| Full Name | Gateway Bhs - Scs Bonaventure C & A Outpatient |
|---|---|
| Speciality | Counselor |
| Location | 415 Bonaventure Rd, Thunderbolt, Georgia |
| Authorized Official Name and Position | Rachel Skinner (DIRECTOR OF REIMBURSEMENT) |
| Authorized Official Contact | 9125548498 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gateway Bhs - Scs Bonaventure C & A Outpatient 700 Coastal Village Dr Brunswick GA 31520-1974 Ph: (912) 554-8510 | Gateway Bhs - Scs Bonaventure C & A Outpatient 415 Bonaventure Rd Thunderbolt GA 31404-3299 Ph: (912) 790-6527 |
| NPI Number | 1891824025 |
|---|---|
| Provider Enumeration Date | 03/05/2007 |
| Last Update Date | 11/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891824025 | NPI | - | NPPES |
| 000859141A | Medicaid | GA | |
| 000859141B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
Gateway Bhs - Scs Bonaventure Adult Outpatient Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 415 Bonaventure Rd, Thunderbolt, GA 31404 Phone: 912-790-6527 Fax: 912-644-7729 | |
Gateway Bhs - Chatham Tc Now Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 415 Bonaventure Rd, Thunderbolt, GA 31404 Phone: 912-790-6526 Fax: 912-790-3460 |