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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