Organization
OUR SPOT
Active
Other names
The Spot
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROOSEVELT CONE (OWNER/DIRECTOR)
(912) 541-2809
Entity
Organization
Contact information
Practice address
1015 E INMAN ST, STATESBORO, GA 30458-2049
(912) 541-2809
Mailing address
1015 E INMAN ST, STATESBORO, GA 30458-2049
(912) 541-2809
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
13BL0437
GA
Other
Enumeration date
05/13/2013
Last updated
01/21/2015
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