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Organization

TARA POLSON

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BARBARA MEDEIROS (BUSINESS MANAGER)
(912) 356-2546
Entity
Organization

Contact information

Practice address
1915 EISENHOWER DR, SAVANNAH, GA 31406-5027
(912) 353-3079
Mailing address
1915 EISENHOWER DR, SAVANNAH, GA 31406-5027
(912) 353-3079

Taxonomy

Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
PSY003415
GA

Other

Enumeration date
10/27/2011
Last updated
03/13/2012
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