Provision Dui Treatment | |
230 S Jackson St Albany GA 31701-2885 | |
(229) 449-2575 | |
Not Available |
Full Name | Provision Dui Treatment |
---|---|
Speciality | Community/behavioral Health |
Location | 230 S Jackson St, Albany, Georgia |
Authorized Official Name and Position | David Berry (CEO) |
Authorized Official Contact | 2294492575 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Provision Dui Treatment 230 S Jackson St Albany GA 31701-2885 Ph: (229) 449-2575 | Provision Dui Treatment 230 S Jackson St Albany GA 31701-2885 Ph: (229) 449-2575 |
NPI Number | 1174997688 |
---|---|
Provider Enumeration Date | 11/20/2015 |
Last Update Date | 11/20/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174997688 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 101YA0400X (Georgia) | Primary |
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