Organization
CSB OF EAST CENTRAL GEORGIA
Active
Other names
Wilkes County Mental Health
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA L. JESSIE (BILLING MANAGER)
(706) 432-4858
Entity
Organization
Contact information
Practice address
124 GORDON ST, WASHINGTON, GA 30673-1602
(706) 678-1395
(706) 432-3780
Mailing address
124 GORDON ST, WASHINGTON, GA 30673-1602
(706) 792-7267
(706) 432-3780
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000606317F
—
GA
Enumeration date
11/27/2006
Last updated
06/19/2008
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