Organization
OCONEE COMMUNITY SERVICE BOARD
Active
Organization
OCONEE COMMUNITY SERVICE BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWANNA DOWNING (OPERATIONS DIRECTOR)
(478) 445-4817
Entity
Organization
Contact information
Practice address
822 GOLDEN HAWK DR, SANDERSVILLE, GA 31082-7034
(478) 552-5215
Mailing address
PO BOX 1827, MILLEDGEVILLE, GA 31059-1827
(478) 445-4817
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000604469I
—
GA
01
—
00611223A
RX MEDICAID PROVIDER NUMB
GA
Enumeration date
09/25/2007
Last updated
09/26/2023
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