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Organization

MCINTOSH TRAIL CSB

Active
Other names
Upson Co Counseling Center
Organization subpart
No

Provider details

NPI number
Authorized official
SHARI THOMAS (CFO)
(770) 358-8254
Entity
Organization

Contact information

Practice address
713 ANDREWS DR, THOMASTON, GA 30286-4524
(770) 358-5252
Mailing address
1435 N EXPRESSWAY, SUITE 301, GRIFFIN, GA 30223-9016
(770) 358-8250
(770) 229-3223

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000601609K
GA
Enumeration date
02/13/2008
Last updated
12/17/2015
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