Organization
OCONEE COMMUNITY SERVICE BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA WEAVER (OFFICE MANAGER SYSTEMS)
(478) 445-4971
Entity
Organization
Contact information
Practice address
830 W CHARLTON ST, MILLEDGEVILLE, GA 31061-2606
(478) 445-5255
Mailing address
PO BOX 1827, MILLEDGEVILLE, GA 31059-1827
(478) 445-4817
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00603424K
—
GA
01
—
55002141A
MEDICARE CROSS OVER
GA
01
—
GRP1997
MEDICARE CROSS OVER GROUP
GA
Enumeration date
01/09/2008
Last updated
06/21/2018
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