Organization
FAMILY RECOVERY OF SOUTHWEST GEORGIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL MARION LCSW (MANAGING DIRECTOR)
(229) 456-2022
Entity
Organization
Contact information
Practice address
719 1ST ST SE, MOULTRIE, GA 31768-5509
(229) 456-2022
(912) 550-4909
Mailing address
115 E MAIN ST STE A1B-8L, BUFORD, GA 30518-5727
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
12/27/2018
Last updated
08/04/2022
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