Organization
SOUTH GEORGIA CSB
Active
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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