Organization
SOUTH GEORGIA CSB
Active
Organization
SOUTH GEORGIA CSB
Active
Other names
Behavioral Health Svcs of S GA
Organization subpart
No
Provider details
NPI number
Authorized official
BENJAMIN AKOSA M.D. (PSYCHIATRIST)
(229) 333-5276
Entity
Organization
Contact information
Practice address
334 TIFTON ELDORADO RD, TIFTON, GA 31794-9497
(229) 386-3494
Mailing address
3120 N OAK STREET EXT, SUITE C, VALDOSTA, GA 31602-1007
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
055563
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SSNO
GA
Enumeration date
10/05/2006
Last updated
08/22/2020
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