Pathways Center For Behavioral And Developmental Growth | |
122 D Gordon Commercial Drive Lagrange GA 30240-5740 | |
(706) 845-4054 | |
(706) 845-4430 |
Full Name | Pathways Center For Behavioral And Developmental Growth |
---|---|
Speciality | Community/behavioral Health |
Location | 122 D Gordon Commercial Drive, Lagrange, Georgia |
Authorized Official Name and Position | Jade Russell Benefield (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 7068454045 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Pathways Center For Behavioral And Developmental Growth 122 Gordon Commercial Drive Suite C Lagrange GA 30240-5740 Ph: (706) 845-4045 | Pathways Center For Behavioral And Developmental Growth 122 D Gordon Commercial Drive Lagrange GA 30240-5740 Ph: (706) 845-4054 |
NPI Number | 1922104033 |
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Provider Enumeration Date | 09/15/2006 |
Last Update Date | 06/21/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1922104033 | NPI | - | NPPES |
000599332T | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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