Organization
OUTWARD BOUND COMMUNITY SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DERRICK MCDOW (CEO)
(336) 382-9618
Entity
Organization
Contact information
Practice address
2141 SMYRNA RD SW, CONYERS, GA 30094-6168
(336) 382-9618
Mailing address
2141 SMYRNA RD SW, CONYERS, GA 30094-6168
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
10/09/2014
Last updated
10/09/2014
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