Organization
COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH MORAN (CFO)
(478) 275-6811
Entity
Organization
Contact information
Practice address
762 OLD MILLEN HWY, WAYNESBORO, GA 30830-8808
(706) 437-6854
(706) 437-6851
Mailing address
223 N ANDERSON DR, SWAINSBORO, GA 30401-4440
(478) 289-2683
(478) 289-2798
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000709288C
—
GA
Enumeration date
06/28/2017
Last updated
06/28/2017
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