Organization
FORENSIC COMMUNITY INTEGRATION HOME-ECRH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES JACKSON (INTERM REGIONAL HOSPITAL ADMINISTRA)
(706) 790-2030
Entity
Organization
Contact information
Practice address
2720 MIKE PADGETT HWY, AUGUSTA, GA 30906-3736
(706) 792-7141
Mailing address
3405 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 792-7021
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/21/2007
Last updated
08/22/2020
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