Organization
MCINTOSH TRAIL COMMUNITY SERVICE BOARD
Active
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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