| Georbea Enterprises Llc | |
|
15938 Us Highway 17 Townsend GA 31331-3706 | |
| (912) 342-2788 | |
| (877) 408-8199 |
| Full Name | Georbea Enterprises Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 15938 Us Highway 17, Townsend, Georgia |
| Authorized Official Name and Position | Aundra Simmons Vaughn (OWNER/PROVIDER) |
| Authorized Official Contact | 9123422788 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Georbea Enterprises Llc 1038 Breeze Way Ave Ne Townsend GA 31331-6511 Ph: (912) 342-2788 | Georbea Enterprises Llc 15938 Us Highway 17 Townsend GA 31331-3706 Ph: (912) 342-2788 |
| NPI Number | 1336656578 |
|---|---|
| Provider Enumeration Date | 01/09/2018 |
| Last Update Date | 12/02/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336656578 | NPI | - | NPPES |
| 003201308A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LPC008947 (Georgia) | Primary |