Organization
CORD OF THREE COUNSELING SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLAY D. GILL LPC (EXECUTIVE DIRECTOR)
(912) 282-0992
Entity
Organization
Contact information
Practice address
5920 REESE ST, PATTERSON, GA 31557-5131
(912) 282-0992
(912) 647-0510
Mailing address
PO BOX 151, PATTERSON, GA 31557-0151
(912) 282-0992
(912) 647-0510
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
004088
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003104129A
—
GA
Enumeration date
05/17/2011
Last updated
05/17/2011
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