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Organization
MISS JOS PCH
Active
Organization
MISS JOS PCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOLETHA S WILLIAMS (OWNER/CEO)
(912) 283-4581
Entity
Organization
Contact information
Practice address
601 MCDONALD ST, WAYCROSS, GA 31503-4704
(912) 283-8587
(912) 283-4581
Mailing address
601 MCDONALD ST, WAYCROSS, GA 31503-4704
(912) 283-8587
(912) 283-4581
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
GA
Other
Enumeration date
10/08/2009
Last updated
10/08/2009
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