| Mcintosh Trail Community Service Board | |
|
180 Watson Street Jackson GA 30233-1536 | |
| (770) 229-3125 | |
| Not Available |
| Full Name | Mcintosh Trail Community Service Board |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 180 Watson Street, Jackson, Georgia |
| Authorized Official Name and Position | Pamela Mccollum (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7703588251 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcintosh Trail Community Service Board 1501a Kalamazoo Dr Griffin GA 30224-3919 Ph: (770) 358-8250 | Mcintosh Trail Community Service Board 180 Watson Street Jackson GA 30233-1536 Ph: (770) 229-3125 |
| NPI Number | 1780853168 |
|---|---|
| Provider Enumeration Date | 02/29/2008 |
| Last Update Date | 02/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780853168 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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