Organization
DEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES
Active
Other names
West Central Community Integration Home #1
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HEATHER NIX (MH / DD TEAM LEADER)
(706) 565-0770
Entity
Organization
Contact information
Practice address
13260 UPATOI LN, UPATOI, GA 31829-2143
(706) 565-0770
Mailing address
13260 UPATOI LN, UPATOI, GA 31829-2143
(706) 565-0770
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
—
000870768F
—
GA
Enumeration date
05/15/2009
Last updated
05/15/2009
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