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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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