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Organization

COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA

Active
Other names
Community Mental Health Center of Middle Georgia
Organization subpart
No

Provider details

NPI number
Authorized official
MR. KEITH MORAN (CHIEF FINANCIAL OFFICER)
(478) 272-1190
Entity
Organization

Contact information

Practice address
2121A BELLEVUE RD, DUBLIN, GA 31021-2998
(478) 272-1190
(478) 274-7628
Mailing address
2121A BELLEVUE RD, DUBLIN, GA 31021-2998
(478) 272-1190
(478) 274-7628

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
007-R-0003
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000606284H
GA
05
300030912A
GA
Enumeration date
11/23/2005
Last updated
01/12/2016
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