Organization
DEPARTMENT OF FAMILY AND CHILDREN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM MITCHELL (UNIT MANAGER)
(229) 724-2044
Entity
Organization
Contact information
Practice address
11860 COLUMBIA ST, BLAKELY, GA 39823-2577
(229) 724-2044
(229) 724-2038
Mailing address
PO BOX 747, BLAKELY, GA 39823-0747
(229) 724-2044
(229) 724-2038
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39823
—
GA
Enumeration date
05/22/2019
Last updated
05/22/2019
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