Organization
CHOICES FOR LIFE OF GEORGIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARA RILEY EXECUTIVE DIRECTOR (EXECUTIVE DIRECTOR)
(229) 244-1707
Entity
Organization
Contact information
Practice address
2200 N PATTERSON STREET, SUITE D, VALDOSTA, GA 31602-2573
(229) 244-1707
(229) 244-1779
Mailing address
2200 N PATTERSON STREET, SUITE D, VALDOSTA, GA 31602-2573
(229) 244-1707
(229) 244-1779
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CPFC001072
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001462443A
—
GA
05
—
631155790A
—
GA
Enumeration date
03/01/2007
Last updated
04/02/2012
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