Organization
CARECONNECT HEALTH, INC.
Active
Other names
CareConnect Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA YOUNG (EXECUTIVE SECRETARY)
(229) 273-8881
Entity
Organization
Contact information
Practice address
254 WRIGHT AVENUE, ROBERTA, GA 31078
(229) 384-5576
(229) 384-5527
Mailing address
PO BOX 5610, CORDELE, GA 31010-5610
(229) 273-8881
(229) 273-8985
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
=========
TAX IDENTIFICATION NUMBER
GA
Enumeration date
01/07/2020
Last updated
05/09/2022
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