| Sparrow Center Llc | |
|
2402 Dawson Rd Ste 6 Albany GA 31707-2380 | |
| (229) 999-6804 | |
| (229) 466-2661 |
| Full Name | Sparrow Center Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2402 Dawson Rd Ste 6, Albany, Georgia |
| Authorized Official Name and Position | Ashley Nicole Hall (OWNER/CEO) |
| Authorized Official Contact | 2299996804 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sparrow Center Llc 2402 Dawson Rd Ste 6 Albany GA 31707-2380 Ph: (229) 999-6804 | Sparrow Center Llc 2402 Dawson Rd Ste 6 Albany GA 31707-2380 Ph: (229) 999-6804 |
| NPI Number | 1366023434 |
|---|---|
| Provider Enumeration Date | 04/19/2021 |
| Last Update Date | 11/15/2022 |
| Certification Date | 11/15/2022 |
| Medicare PECOS PAC ID | 1658762158 |
|---|---|
| Medicare Enrollment ID | O20211216001995 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366023434 | NPI | - | NPPES |
| 003262221A | Medicaid | GA |
| Provider Name | Ashley Nicole Hall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710512264 PECOS PAC ID: 2567853062 Enrollment ID: I20211216002173 |
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