# CONEBLAA FAMILY FOUNDATION CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194026807
- **Authorized official:** MS. LORETTA GORDON PASTOR (DIRECTOR)
- **Authorized official phone:** (478) 254-2878

## Contact information

- **Practice address:** 1950 PINE HILL DR, MACON, GA 31217-4434
- **Practice address phone:** (478) 254-2878
- **Mailing address:** 1950 PINE HILL DR, MACON, GA 31217-4434
- **Mailing address phone:** (478) 254-2878

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP1600X | Pastoral Counselor | — | NULL | Yes |
| 101YP1600X | Pastoral Counselor | — | — | Yes |

## Other

- **Enumeration date:** 11/11/2010
- **Last updated:** 11/11/2010