| |
322 Milledgeville Hwy Gordon GA 31031-4177 | |
(478) 628-4054 | |
Not Available |
Full Name | |
---|---|
Speciality | Community/behavioral Health |
Location | 322 Milledgeville Hwy, Gordon, Georgia |
Authorized Official Name and Position | Pamela Reaves (OWNER/CEO) |
Authorized Official Contact | 4786284054 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 703 126 Shinholster Gordon GA 31031-0703 Ph: (478) 628-4054 | 322 Milledgeville Hwy Gordon GA 31031-4177 Ph: (478) 628-4054 |
NPI Number | 1528326055 |
---|---|
Provider Enumeration Date | 05/03/2012 |
Last Update Date | 05/03/2012 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528326055 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |