Organization
SOUTHERN BRIDGE COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARLA JACKSON (CO OWNER)
(910) 689-5190
Entity
Organization
Contact information
Practice address
100 SHOSHONE CIRCLE, KATHLEEN, GA 31047
(910) 689-5190
Mailing address
100 SHOSHONE CIRCLE, KATHLEEN, GA 31047
(910) 689-5190
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
02/17/2016
Last updated
02/17/2016
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