Organization
SOUTH GEORGIA TREATMENT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICOLE RAE MCCONNELL (ADMINISTRATOR)
(770) 775-9044
Entity
Organization
Contact information
Practice address
794 MCDONOUGH RD, JACKSON, GA 30233-1572
(770) 775-9044
Mailing address
794 MCDONOUGH RD, JACKSON, GA 30233-1572
(770) 775-9044
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
NTP-001027
GA
Other
Enumeration date
09/04/2008
Last updated
09/04/2008
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