| Renee Smith | |
|
2009 Burma Rd Rossville GA 30741-3813 | |
| (706) 638-5580 | |
| (706) 639-2054 |
| Full Name | Renee Smith |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 2009 Burma Rd, Rossville, Georgia |
| Authorized Official Name and Position | Tom Ford (CEO) |
| Authorized Official Contact | 7066385584 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renee Smith Po Box 1027 La Fayette GA 30728-1027 Ph: (706) 638-5580 | Renee Smith 2009 Burma Rd Rossville GA 30741-3813 Ph: (706) 638-5580 |
| NPI Number | 1518415439 |
|---|---|
| Provider Enumeration Date | 09/20/2016 |
| Last Update Date | 09/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518415439 | NPI | - | NPPES |
| 000810059N | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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