Organization
DIVERSITY HEALTH CENTER INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. STEPHANIE JONES-THEAKER (CEO)
(912) 318-3947
Entity
Organization
Contact information
Practice address
502 E GENERAL STEWART WAY STE A, HINESVILLE, GA 31313-2643
(912) 318-3947
(912) 877-0189
Mailing address
PO BOX 1520, HINESVILLE, GA 31310-8520
(912) 318-3947
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
20843
GA
Other
Enumeration date
08/26/2016
Last updated
08/26/2016
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