Organization
OCONEE COMMUNITY SERVICE BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA WEAVER (OFFICE SYSTEMS MANAGER)
(478) 445-4971
Entity
Organization
Contact information
Practice address
101 EAST SUMPTER, EATONTON, GA 31024
(706) 485-6573
Mailing address
101 EAST SUMPTER, EATONTON, GA 31024
(706) 485-6573
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55002141A
MEDICARE CROSS OVER
GA
01
—
GRP1997
MEDICARE PROVIDER NUMBER
GA
Enumeration date
09/24/2007
Last updated
06/21/2018
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