Organization
GEORGIA PINES COMMUNITY SERVICE BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT H JONES (EXECUTIVE DIRECTOR)
(229) 225-4373
Entity
Organization
Contact information
Practice address
14244 US HIGHWAY 19 S, THOMASVILLE, GA 31757-4800
(229) 225-4335
(229) 225-4374
Mailing address
1102 SMITH AVE, THOMASVILLE, GA 31792-5739
(229) 225-4335
(229) 225-4374
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000606372G
—
GA
01
—
782543000
MAGELLAN
—
Enumeration date
12/28/2006
Last updated
07/26/2013
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