Organization
DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES
Active
Other names
Adolescent Transitional Living Program (Boys)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK GARCIA (SERVICE DIRECTOR)
(706) 568-5118
Entity
Organization
Contact information
Practice address
6126 ARNOLD DR, COLUMBUS, GA 31907-1904
(706) 507-3441
Mailing address
6126 ARNOLD DR, COLUMBUS, GA 31907-1904
(706) 507-3441
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
N/A-PER CALL TO NPI
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000870768E
—
GA
Enumeration date
08/09/2006
Last updated
05/15/2009
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