| L.i.f.e. Cs-csi Division, Llc | |
|
710 Bowery Ln Bldg.g Box # 41 Folkston GA 31537-5967 | |
| (912) 496-2616 | |
| (912) 496-0817 |
| Full Name | L.i.f.e. Cs-csi Division, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 710 Bowery Ln, Folkston, Georgia |
| Authorized Official Name and Position | Donna Kay Thompson-lisiecki (OWNER) |
| Authorized Official Contact | 9124962616 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| L.i.f.e. Cs-csi Division, Llc 710 Bowery Ln Bldg.g Box # 41 Folkston GA 31537-5967 Ph: (912) 496-2616 | L.i.f.e. Cs-csi Division, Llc 710 Bowery Ln Bldg.g Box # 41 Folkston GA 31537-5967 Ph: (912) 496-2616 |
| NPI Number | 1962756163 |
|---|---|
| Provider Enumeration Date | 11/09/2012 |
| Last Update Date | 04/10/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962756163 | NPI | - | NPPES |
| 193400000X | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 045321 (Georgia) | Primary |
Charlton C&a Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 396 Kingsland Dr, Folkston, GA 31537 Phone: 912-449-7109 Fax: 912-449-7056 | |
T Hoffler Enterprises Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 105 Kay St, Pob 98, Folkston, GA 31537 Phone: 912-496-3509 Fax: 912-496-0850 | |
L.i.f.e. Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 Bowery Ln, Building G Box 41, Folkston, GA 31537 Phone: 912-496-2616 Fax: 912-496-2671 |