Organization
RE-DIRECT BEHAVIORAL YOUTH PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE NATHAN RICKS ETC. (CEO)
(478) 697-5304
Entity
Organization
Contact information
Practice address
900 MLK JR DR, DUBLIN, GA 31021-5063
(478) 304-1403
Mailing address
PO BOX 16355, DUBLIN, GA 31040-6355
(478) 697-5304
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
08/05/2019
Last updated
08/05/2019
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