Organization
GEORGIA DFCS REGION 12
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY HUNTER (FISCAL OPERATION MANAGER)
(912) 554-3480
Entity
Organization
Contact information
Practice address
823 SCRANTON RD, BRUNSWICK, GA 31525-6601
(912) 554-3480
Mailing address
PO BOX 580, BRUNSWICK, GA 31521-0580
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
—
—
177F00000X
Lodging Provider
—
—
Other
Enumeration date
06/13/2019
Last updated
06/13/2019
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