Organization
SOUTH GEORGIA CSB
Active
Other names
Project Light
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUE GUPTON (CHIEF EXECUTIVE OFFICER)
(229) 245-2379
Entity
Organization
Contact information
Practice address
1108 S PATTERSON ST, VALDOSTA, GA 31601-6348
(229) 245-6410
(229) 293-6242
Mailing address
1108 S PATTERSON ST, VALDOSTA, GA 31601-6348
(229) 245-6410
(229) 293-6242
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
11/20/2006
Last updated
08/22/2020
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