Organization
OGEECHEE BEHAVIORAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA RICHBOURG LPC (EXECUTIVE DIRECTOR)
(478) 289-2522
Entity
Organization
Contact information
Practice address
1114 CLARKS MILL RD, LOUISVILLE, GA 30434-5304
(478) 625-7214
Mailing address
223 N ANDERSON DR, P O BOX 1259, SWAINSBORO, GA 30401-4440
(478) 289-2522
(478) 289-2544
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000709288T
—
GA
Enumeration date
01/06/2010
Last updated
01/06/2010
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