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463 Ernest Biles Dr Suite B Jackson GA 30233-2229 | |
| (770) 775-2676 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 463 Ernest Biles Dr, Jackson, Georgia |
| Authorized Official Name and Position | Shari Thomas (CFO) |
| Authorized Official Contact | 7703588254 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1435 N Expressway Suite 301 Griffin GA 30223-9016 Ph: (770) 358-8250 | 463 Ernest Biles Dr Suite B Jackson GA 30233-2229 Ph: (770) 775-2676 |
| NPI Number | 1265610406 |
|---|---|
| Provider Enumeration Date | 02/08/2008 |
| Last Update Date | 12/17/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265610406 | NPI | - | NPPES |
| 000601609A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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