Organization
SOUTH GEORGIA CSB
Active
Other names
New Beginnings
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA HARRELL (CHIEF FINANCIAL OFFICER)
(229) 671-6140
Entity
Organization
Contact information
Practice address
252 N SAINT AUGUSTINE RD, VALDOSTA, GA 31601-5274
(229) 245-6400
(229) 249-4996
Mailing address
252 N SAINT AUGUSTINE RD, VALDOSTA, GA 31601-5274
(229) 245-6400
(229) 249-4996
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
—
0000742475O
—
GA
Enumeration date
11/16/2006
Last updated
01/08/2009
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