Organization
MIDDLE GEORGIA FAMILY REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRENDA HICKS (OWNER/CEO)
(478) 538-1436
Entity
Organization
Contact information
Practice address
100 HAMILTON POINTE DRIVE, 115, BYRON, GA 31008
(478) 538-1436
Mailing address
P.O. BOX 1552, 115, BYRON, GA 31008
(478) 845-3520
(478) 956-0958
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
07/24/2013
Last updated
10/31/2021
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