Organization
GEORGIA PINES COMMUNITY SERVICE BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONAS NORMAN (CLERICAL SUPPORT)
(229) 225-5031
Entity
Organization
Contact information
Practice address
105 BERMUDA ST, THOMASVILLE, GA 31792-4018
(229) 233-8902
Mailing address
1102 SMITH AVE STE K, THOMASVILLE, GA 31792-5740
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000754795H
—
GA
Enumeration date
02/09/2018
Last updated
02/09/2018
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