West Central Community Integration Home #1 | |
13260 Upatoi Ln Upatoi GA 31829-2143 | |
(706) 565-0770 | |
Not Available |
Full Name | West Central Community Integration Home #1 |
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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 |
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West Central Community Integration Home #1 13260 Upatoi Ln Upatoi GA 31829-2143 Ph: (706) 565-0770 | West Central Community Integration Home #1 13260 Upatoi Ln Upatoi GA 31829-2143 Ph: (706) 565-0770 |
NPI Number | 1386879666 |
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Provider Enumeration Date | 05/15/2009 |
Last Update Date | 05/15/2009 |
Identifier | Type | State | Issuer |
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1386879666 | NPI | - | NPPES |
000870768F | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Community Integration Home Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 13260 Upatoi Ln, Upatoi, GA 31829 Phone: 706-565-0770 |