Organization
MCDUFFIE COUNTY MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WANDA JESSIE (BILLING MANAGER)
(706) 432-4858
Entity
Organization
Contact information
Practice address
306 GREENWAY ST, THOMSON, GA 30824-2723
(706) 595-2739
Mailing address
306 GREENWAY ST, THOMSON, GA 30824-2723
(706) 595-2739
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006060317B
—
GA
Enumeration date
12/14/2009
Last updated
12/14/2009
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