| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 302 W I Pkwy, Dallas, Georgia |
| Authorized Official Name and Position | George Williams (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6788586283 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
302 W I Pkwy Dallas GA 30132-5061 Ph: (678) 363-3799 | 302 W I Pkwy Dallas GA 30132-5061 Ph: (678) 363-3799 |
| NPI Number | 1225253354 |
|---|---|
| Provider Enumeration Date | 04/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225253354 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Georgia) | Primary |
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