Organization
ALTERNATE PATHS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOHNNIE C HARDY MPA (CHIEF OPERATIONS OFFICER)
(404) 358-4076
Entity
Organization
Contact information
Practice address
990 MOUNT ZION RD, OXFORD, GA 30054-4023
(404) 358-4076
(770) 358-5017
Mailing address
990 MOUNT ZION RD, OXFORD, GA 30054-4023
(404) 358-4076
(770) 358-5017
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
251S00000X
GA
Other
Enumeration date
07/16/2008
Last updated
07/16/2008
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