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355 Bobwhite Trl Grovetown GA 30813-5886 | |
| (706) 432-4837 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 355 Bobwhite Trl, Grovetown, Georgia |
| Authorized Official Name and Position | Michele Prior (BILLING MANAGER) |
| Authorized Official Contact | 7064324837 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3421 Mike Padgett Hwy Augusta GA 30906-3815 Ph: () - | 355 Bobwhite Trl Grovetown GA 30813-5886 Ph: (706) 432-4837 |
| NPI Number | 1023516002 |
|---|---|
| Provider Enumeration Date | 01/25/2018 |
| Last Update Date | 01/25/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023516002 | NPI | - | NPPES |
| 000605833Y | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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