| |
100 Macon St North Oglethorpe GA 31068 | |
(229) 931-2470 | |
(229) 931-2474 |
Full Name | |
---|---|
Speciality | Community/behavioral Health |
Location | 100 Macon St North, Oglethorpe, Georgia |
Authorized Official Name and Position | Pam Davis (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2299312470 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
415 N Jackson St P.o. Drawer Americus GA 31709-3015 Ph: (229) 931-2470 | 100 Macon St North Oglethorpe GA 31068 Ph: (229) 931-2470 |
NPI Number | 1811165699 |
---|---|
Provider Enumeration Date | 02/14/2008 |
Last Update Date | 02/14/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1811165699 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |