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Organization

AWAY OUT, INC.

Active
Parent organization
AWAY OUT, INC.
Organization subpart
Yes

Provider details

NPI number
Legal business name
AWAY OUT, INC.
Authorized official
MR. EDDIE D POWELL LPC (CEO)
(706) 653-0068
Entity
Organization

Contact information

Practice address
416 12TH ST STE 202, COLUMBUS, GA 31901-2558
(706) 653-0068
Mailing address
416 12TH STREET SUITE 202, COLUMBUS, GA 31901
(706) 653-0068

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
LPC2759
GA
251S00000X
Community/Behavioral Health Agency
Primary
LPC2759
GA

Other

Enumeration date
06/03/2010
Last updated
06/03/2010
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