| |
1524 S Lee St Americus GA 31709-4413 | |
(229) 931-2829 | |
(229) 931-2474 |
Full Name | |
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Speciality | Community/behavioral Health |
Location | 1524 S Lee St, Americus, Georgia |
Authorized Official Name and Position | Elizabeth Ragan (CEO) |
Authorized Official Contact | 2299312470 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1348 415 N Jackson St. Americus GA 31709-1348 Ph: (229) 931-2470 | 1524 S Lee St Americus GA 31709-4413 Ph: (229) 931-2829 |
NPI Number | 1518201375 |
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Provider Enumeration Date | 11/19/2012 |
Last Update Date | 11/19/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518201375 | NPI | - | NPPES |
003128168A | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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