Organization
SHANE'S CRIB
Active
Organization
SHANE'S CRIB
Active
Parent organization
MASA TAKE BY FORCE MINISTRIES
Organization subpart
Yes
Provider details
NPI number
Legal business name
MASA TAKE BY FORCE MINISTRIES
Authorized official
MRS. CHERYL E MAINOR LPC (DIRECTOR)
(912) 385-2583
Entity
Organization
Contact information
Practice address
1303 SOUTH 1ST STREET, JESUP, GA 31545
(912) 385-2583
(912) 385-2583
Mailing address
1303 S 1ST ST, JESUP, GA 31545-7757
(912) 385-2583
(912) 385-2583
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
CSW003662
GA
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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