| Provision Dui Treatment | |
|
230 S Jackson St Albany GA 31701-2885 | |
| (229) 449-2575 | |
| Not Available |
| Full Name | Provision Dui Treatment |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 230 S Jackson St, Albany, Georgia |
| Authorized Official Name and Position | David Berry (CEO) |
| Authorized Official Contact | 2294492575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Provision Dui Treatment 230 S Jackson St Albany GA 31701-2885 Ph: (229) 449-2575 | Provision Dui Treatment 230 S Jackson St Albany GA 31701-2885 Ph: (229) 449-2575 |
| NPI Number | 1174997688 |
|---|---|
| Provider Enumeration Date | 11/20/2015 |
| Last Update Date | 11/20/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174997688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 101YA0400X (Georgia) | Primary |
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