| NPI | 1740433036 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER C MANN-MACKEY Director Of Behavioral Health/Lpc 912-427-1499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA 002644) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: GA 002644) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2008-10-30 |