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Organization

PINE LAKE BEHAVIORAL SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JERRY MCMAHON (GENERAL PARTNER)
(404) 298-6263
Entity
Organization

Contact information

Practice address
433 HEMLOCK DRIVE, PINE LAKE, GA 30072
(404) 298-6263
Mailing address
PO BOX 1502, PINE LAKE, GA 30072-1502

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary

Other

Enumeration date
03/19/2009
Last updated
03/19/2009
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