Organization
WISDOM SOLUTIONS OF THE CSRA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMARA AUGUSTIN NOEL LCSW (CEO/CLINICAL DIRECTOR)
(706) 592-8424
Entity
Organization
Contact information
Practice address
3711 EXECUTIVE CENTER DR, SUITE 101, MARTINEZ, GA 30907-0951
(706) 592-8424
(706) 269-2966
Mailing address
3711 EXECUTIVE CENTER DR, SUITE 101, MARTINEZ, GA 30907-0951
(706) 592-8424
(706) 269-2966
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
CSW005228
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003157541A
—
GA
Enumeration date
02/04/2016
Last updated
10/21/2016
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