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100 Heads Ave Americus GA 31709-3616 | |
| (229) 931-2470 | |
| (229) 931-2474 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 100 Heads Ave, Americus, Georgia |
| Authorized Official Name and Position | Margaret Jordan (UTILIZATION MANAGER) |
| Authorized Official Contact | 2298155286 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
415 N Jackson St P.o. Drawer 1348 Americus GA 31709-3015 Ph: (229) 931-2470 | 100 Heads Ave Americus GA 31709-3616 Ph: (229) 931-2470 |
| NPI Number | 1891963518 |
|---|---|
| Provider Enumeration Date | 02/15/2008 |
| Last Update Date | 12/29/2021 |
| Certification Date | 12/29/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891963518 | NPI | - | NPPES |
| 000603237J | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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