Organization
WAYNE BEHAVORIAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER C MANN-MACKEY LPC (DIRECTOR OF BEHAVIORAL HEALTH/LPC)
(912) 427-1499
Entity
Organization
Contact information
Practice address
1245 S 1ST ST, JESUP, GA 31545-7729
(912) 427-1499
(912) 427-2358
Mailing address
PO BOX 37, 1245 SOUTH 1ST STREET, JESUP, GA 31598-0037
(912) 427-1499
(912) 427-2358
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
002644
GA
305R00000X
Preferred Provider Organization
Primary
002644
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
369579212
—
GA
05
—
369579212A
—
GA
Enumeration date
10/30/2008
Last updated
10/30/2008
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