Organization
MIDDLE GEORGIA ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LATTAKKA S SALLEY (GENERAL PARTNER)
(478) 273-3086
Entity
Organization
Contact information
Practice address
507 N DAVIS DR STE 1A, WARNER ROBINS, GA 31093-2687
(478) 273-4024
(478) 352-0125
Mailing address
507 N DAVIS DR STE 1A, WARNER ROBINS, GA 31093-2687
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
2084P0800X
Psychiatry Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
03/21/2018
Last updated
08/20/2021
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