| Tift C&a Outpatient Services | |
|
340 Tifton Eldorado Road Tifton GA 31794 | |
| (229) 391-2350 | |
| (229) 386-7099 |
| Full Name | Tift C&a Outpatient Services |
|---|---|
| Speciality | Clinic/center - Adolescent And Children Mental Health |
| Location | 340 Tifton Eldorado Road, Tifton, Georgia |
| Authorized Official Name and Position | Charles R Powell (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2296716101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tift C&a Outpatient Services 340 Tifton Eldorado Road Tifton GA 31794 Ph: (229) 391-2350 | Tift C&a Outpatient Services 340 Tifton Eldorado Road Tifton GA 31794 Ph: (229) 391-2350 |
| NPI Number | 1942374343 |
|---|---|
| Provider Enumeration Date | 11/17/2006 |
| Last Update Date | 03/17/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942374343 | NPI | - | NPPES |
| 777050079A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Primary |
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