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382 Jowers Rd Whigham GA 39897-2162 | |
(229) 762-3150 | |
(229) 762-3110 |
Full Name | |
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Speciality | Clinic/center - Adult Mental Health |
Location | 382 Jowers Rd, Whigham, Georgia |
Authorized Official Name and Position | Linda K Gordon (ADMINSTRATOR) |
Authorized Official Contact | 2297623150 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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382 Jowers Rd Po Box 409 Whigham GA 39897-2162 Ph: (229) 762-3150 | 382 Jowers Rd Whigham GA 39897-2162 Ph: (229) 762-3150 |
NPI Number | 1790055903 |
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Provider Enumeration Date | 01/04/2012 |
Last Update Date | 01/04/2012 |
Identifier | Type | State | Issuer |
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1790055903 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM0850X | Clinic/center - Adult Mental Health | 065010161 (Georgia) | Primary |