Organization
CENTRAL GA FAMILY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLARENCE HICKS (OWNER)
(478) 845-3520
Entity
Organization
Contact information
Practice address
100 HAMILTON POINTE DR, BYRON, GA 31008-6271
(478) 845-3520
(478) 621-7233
Mailing address
PO BOX 27393, MACON, GA 31221-7393
(478) 845-3520
(478) 621-7233
Taxonomy
Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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