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
251S00000X
Community/Behavioral Health Agency
—
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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