| Sexual Assault Center Of Northwest Georgia, Inc | |
|
414 Shorter Ave Nw Rome GA 30165-4274 | |
| (706) 292-9024 | |
| (706) 292-0114 |
| Full Name | Sexual Assault Center Of Northwest Georgia, Inc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 414 Shorter Ave Nw, Rome, Georgia |
| Authorized Official Name and Position | Kim Davis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 70629299024 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sexual Assault Center Of Northwest Georgia, Inc 414 Shorter Ave Nw Rome GA 30165-4274 Ph: () - | Sexual Assault Center Of Northwest Georgia, Inc 414 Shorter Ave Nw Rome GA 30165-4274 Ph: (706) 292-9024 |
| NPI Number | 1871041848 |
|---|---|
| Provider Enumeration Date | 09/19/2016 |
| Last Update Date | 09/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871041848 | NPI | - | NPPES |
| 23566666 | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | APC005441 (Georgia) | Primary |
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