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Organization
CSB OF EAST CENTRAL GEORGIA
Active
Organization
CSB OF EAST CENTRAL GEORGIA
Active
Other names
Wilkes County Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA L. JESSIE (BILLING MANAGER)
(706) 432-4858
Entity
Organization
Contact information
Practice address
124 GORDON ST, WASHINGTON, GA 30673-1602
(706) 678-1395
(706) 432-3780
Mailing address
124 GORDON ST, WASHINGTON, GA 30673-1602
(706) 792-7267
(706) 432-3780
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000606317F
—
GA
Enumeration date
11/27/2006
Last updated
06/19/2008
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