| Bacchus Operations Group, Inc | |
|
509 Sumter St Montezuma GA 31063-1733 | |
| (478) 472-3100 | |
| (478) 472-3248 |
| Full Name | Bacchus Operations Group, Inc |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 509 Sumter St, Montezuma, Georgia |
| Authorized Official Name and Position | Michael C Patterson (CEO) |
| Authorized Official Contact | 4784723100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bacchus Operations Group, Inc 509 Sumter St Montezuma GA 31063-1733 Ph: (478) 472-3100 | Bacchus Operations Group, Inc 509 Sumter St Montezuma GA 31063-1733 Ph: (478) 472-3100 |
| NPI Number | 1033427570 |
|---|---|
| Provider Enumeration Date | 09/17/2010 |
| Last Update Date | 06/10/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033427570 | NPI | - | NPPES |
| 11S190 | Other | GA | MEDICARE PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
Premier Healthcare Investments Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 509 Sumter St, Montezuma, GA 31063 Phone: 478-472-3100 Fax: 478-472-3248 |