| NPI | 1518031863 |
|---|---|
| Other Name | JACKSON MH |
| Entity Type | Organization |
| Authorized Contact | GLENN BUTLER Billing Mgr 706-227-7250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |