Organization
GEORGIA DEPARTMENT OF HUMAN RESOURCES
Active
Other names
East Central Developmental System
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAIL C JACKSON M.D. (REGIONAL HOSPITAL ADMINISTRATOR)
(706) 790-2030
Entity
Organization
Contact information
Practice address
100 MYRTLE BLVD, GRACEWOOD, GA 30812-1500
(706) 790-2030
Mailing address
100 MYRTLE BLVD, GRACEWOOD, GA 30812-1500
(706) 790-2030
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
21211622
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00869206A
—
GA
Enumeration date
12/14/2006
Last updated
08/22/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us