Organization
MIDDLE GEORGIA BEHAVIORAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA H MORRLL (BILLING MANAGER)
(478) 275-4845
Entity
Organization
Contact information
Practice address
402 W MADISON ST, DUBLIN, GA 31021-5232
(478) 275-4845
(478) 277-9192
Mailing address
402 W MADISON ST, PO BOX 635, DUBLIN, GA 31021-5232
(478) 275-4845
(478) 277-9192
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
845236863A
—
GA
05
—
845236863B
—
GA
Enumeration date
10/09/2008
Last updated
10/09/2008
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