# GEORGIA DEPT. OF CORRECTIONS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1578942769
- **Authorized official:** DR. TIMOTHY YOUNG M.D. (CLINIC DIRECTOR)
- **Authorized official phone:** (706) 855-4833

## Contact information

- **Practice address:** 3001 GORDON HWY, GROVETOWN, GA 30813-3808
- **Practice address phone:** (706) 855-4984
- **Mailing address:** 645 SIMONTON CREST DR, LAWRENCEVILLE, GA 30045-3512
- **Mailing address phone:** (770) 377-6580

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | 2678 | GA | Yes |

## Other

- **Enumeration date:** 05/21/2015
- **Last updated:** 05/21/2015