Organization
MIDDLE FLINT COMMUNITY BOARD
Active
Other names
CRISP COMMUNITY MENTAL HEALTH CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
PAM DAVIS (EXEC DIR)
(229) 931-2470
Entity
Organization
Contact information
Practice address
1335 N 5TH STREET EXT, CORDELE, GA 31015-3753
(229) 276-2367
(229) 931-2474
Mailing address
PO BOX 1348, AMERICUS, GA 31709-1348
(229) 931-2474
(229) 931-2474
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
PHRE006306
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015417
PK
—
05
—
734807561B
—
GA
Enumeration date
07/30/2006
Last updated
09/16/2016
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