| Kids Zone Behavioral Health, Inc | |
|
321 B Greenville Street Lagrange GA 30241 | |
| (706) 887-5787 | |
| (706) 780-5402 |
| Full Name | Kids Zone Behavioral Health, Inc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 321 B Greenville Street, Lagrange, Georgia |
| Authorized Official Name and Position | Jordan Lyndsey Child (OWNER & CLINICIAN) |
| Authorized Official Contact | 7068875787 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids Zone Behavioral Health, Inc 321 B Greenville Street Lagrange GA 30241 Ph: (706) 887-5787 | Kids Zone Behavioral Health, Inc 321 B Greenville Street Lagrange GA 30241 Ph: (706) 887-5787 |
| NPI Number | 1336639582 |
|---|---|
| Provider Enumeration Date | 05/14/2018 |
| Last Update Date | 09/18/2023 |
| Certification Date | 09/18/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336639582 | NPI | - | NPPES |
| 003205328A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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