Organization
GRN COMMUNITY SERVICE BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE LEA BAGBY (FAIMLY ADVOCATE)
(770) 785-5910
Entity
Organization
Contact information
Practice address
1430 STAR CREST DRIVE, CONYERS, GA 30012-6315
(770) 785-5910
Mailing address
6203 NIXON CIR NE, COVINGTON, GA 30014-6315
(678) 342-0814
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/16/2007
Last updated
08/22/2020
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