Organization
SOUTH GEORGIA CSB
Active
Organization
SOUTH GEORGIA CSB
Active
Other names
Lanier DD Services
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUE GUPTON (CHIEF EXECUTIVE OFFICER)
(229) 671-6101
Entity
Organization
Contact information
Practice address
321 W BRANTLEY, LAKELAND, GA 31635
(229) 482-2820
(229) 482-8012
Mailing address
321 W BRANTLEY, LAKELAND, GA 31635
(229) 482-2820
(229) 482-8012
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
11/17/2006
Last updated
12/15/2008
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