Organization
GENCARE OF GEORGIA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. EXIE RUTH BUFFINGTON (CLINICAL DIRECTOR)
(706) 276-2273
Entity
Organization
Contact information
Practice address
11 KIKER ST, EAST ELLIJAY, GA 30540
(706) 276-2273
(706) 276-2277
Mailing address
PO BOX 1119, EAST ELLIJAY, GA 30539
(706) 276-2273
(706) 276-2277
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003104485A
—
GA
Enumeration date
02/05/2010
Last updated
09/13/2011
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