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540 Basin St Augusta GA 30909-3834 | |
| (706) 267-1488 | |
| (706) 592-9247 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 540 Basin St, Augusta, Georgia |
| Authorized Official Name and Position | Yvette Jones (CEO) |
| Authorized Official Contact | 7062671488 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 428 Hephzibah GA 30815-0428 Ph: (706) 267-1488 | 540 Basin St Augusta GA 30909-3834 Ph: (706) 267-1488 |
| NPI Number | 1881013340 |
|---|---|
| Provider Enumeration Date | 04/14/2014 |
| Last Update Date | 04/14/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881013340 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 15458417 (Georgia) | Primary |
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