Organization
METHODIST HOME OF THE SOUTH GA CONFERENCE
Active
Organization
METHODIST HOME OF THE SOUTH GA CONFERENCE
Active
Other names
Methodist Home for Children and Youth
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE L RUMFORD (PRESIDENT AND CEO)
(478) 751-2800
Entity
Organization
Contact information
Practice address
304 PIERCE AVE, MACON, GA 31204-2422
(478) 751-2800
Mailing address
304 PIERCE AVE, MACON, GA 31204-2422
(478) 751-2800
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
CCI11006
GA
251S00000X
Community/Behavioral Health Agency
CI0000011053
GA
251S00000X
Community/Behavioral Health Agency
CI0000012098
GA
251S00000X
Community/Behavioral Health Agency
Primary
CI0000012147
GA
251S00000X
Community/Behavioral Health Agency
CPA001036
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00271679C
—
GA
05
—
00927671B
—
GA
Enumeration date
12/14/2006
Last updated
08/22/2020
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