Organization
MCINTOSH TRAIL COMMUNITY SERVICE BOARD
Active
Other names
McIntosh Tr MH MR SA CSB
Organization subpart
No
Provider details
NPI number
Authorized official
SHARI THOMAS (CFO)
(770) 358-8254
Entity
Organization
Contact information
Practice address
463 ERNEST BILES DR, SUITE B, JACKSON, GA 30233-2229
(770) 775-2676
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
—
000601609A
—
GA
Enumeration date
02/08/2008
Last updated
12/17/2015
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