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Organization

K12 CLINICS

Active
Other names
PSYCHIATRY NETWORK
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ADEREMI S. DOSUNMU M.D. (MEDICAL DIRECTOR)
(912) 877-7924
Entity
Organization

Contact information

Practice address
938 ELMA G. MILES PARKWAY, HINESVILLE, GA 31313
(912) 877-7924
(912) 877-5437
Mailing address
938 E.G. MILES PARKWAY, HINESVILLE, GA 31313
(912) 877-7924
(912) 877-5437

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
047893
GA
261QM0850X
Adult Mental Health Clinic/Center
047893
GA
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
047893
GA

Other

Enumeration date
05/14/2007
Last updated
07/09/2009
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