Organization
ANGELS CORNER LL
Active
Other names
Angels Corner l
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JOANNE B MIMS COUNSELOR (OWNER)
(478) 750-7747
Entity
Organization
Contact information
Practice address
279 HAMPTON RD S, MACON, GA 31217-8536
(478) 750-7747
(478) 750-7747
Mailing address
279 HAMPTON RD S, MACON, GA 31217-8536
(478) 750-7747
(478) 750-7747
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
25896382
GA
261QM0850X
Adult Mental Health Clinic/Center
—
—
311ZA0620X
Adult Care Home Facility
—
—
Other
Enumeration date
09/27/2011
Last updated
09/27/2011
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