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13260 Upatoi Ln Upatoi GA 31829-2143 | |
| (706) 565-0770 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 13260 Upatoi Ln, Upatoi, Georgia |
| Authorized Official Name and Position | Heather Nix (MH / DD TEAM LEADER) |
| Authorized Official Contact | 7065650770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
13260 Upatoi Ln Upatoi GA 31829-2143 Ph: (706) 565-0770 | 13260 Upatoi Ln Upatoi GA 31829-2143 Ph: (706) 565-0770 |
| NPI Number | 1386879666 |
|---|---|
| Provider Enumeration Date | 05/15/2009 |
| Last Update Date | 05/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386879666 | NPI | - | NPPES |
| 000870768F | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |