| Paulding Enterprises, Inc. | |
|
110 Stadium Dr Dallas GA 30132-3610 | |
| (770) 445-6051 | |
| (770) 443-2374 |
| Full Name | Paulding Enterprises, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 110 Stadium Dr, Dallas, Georgia |
| Authorized Official Name and Position | Dawn M. Cable (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7704456051 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paulding Enterprises, Inc. 110 Stadium Dr Dallas GA 30132-3610 Ph: (770) 445-6051 | Paulding Enterprises, Inc. 110 Stadium Dr Dallas GA 30132-3610 Ph: (770) 445-6051 |
| NPI Number | 1992087472 |
|---|---|
| Provider Enumeration Date | 09/12/2011 |
| Last Update Date | 09/12/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992087472 | NPI | - | NPPES |
| 000696847E | Medicaid | GA | |
| 000696847D | Medicaid | GA | |
| 000696847A | Medicaid | GA | |
| 000696847F | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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