Gateway Bhs - Tc Now | |
210 E 15th St Woodbine GA 31569-5501 | |
(912) 576-5075 | |
(912) 576-3543 |
Full Name | Gateway Bhs - Tc Now |
---|---|
Speciality | Psychologist |
Location | 210 E 15th St, Woodbine, Georgia |
Authorized Official Name and Position | William Parks (CFO) |
Authorized Official Contact | 9125548464 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Gateway Bhs - Tc Now 700 Coastal Village Dr Brunswick GA 31520-1974 Ph: (912) 554-8510 | Gateway Bhs - Tc Now 210 E 15th St Woodbine GA 31569-5501 Ph: (912) 576-5075 |
NPI Number | 1992834550 |
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Provider Enumeration Date | 03/02/2007 |
Last Update Date | 10/20/2011 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992834550 | NPI | - | NPPES |
000622553C | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | (* (Not Available)) | Primary |
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