| Oconee Community Service Board | |
|
75 Boland Cir Sparta GA 31087-2007 | |
| (706) 444-1037 | |
| (706) 444-1034 |
| Full Name | Oconee Community Service Board |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 75 Boland Cir, Sparta, Georgia |
| Authorized Official Name and Position | Jennifer B Gheesling (BILLING MANAGER) |
| Authorized Official Contact | 4784454971 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oconee Community Service Board Po Box 1827 Milledgeville GA 31059-1827 Ph: (478) 445-4971 | Oconee Community Service Board 75 Boland Cir Sparta GA 31087-2007 Ph: (706) 444-1037 |
| NPI Number | 1558646380 |
|---|---|
| Provider Enumeration Date | 10/12/2011 |
| Last Update Date | 03/04/2020 |
| Certification Date | 03/04/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558646380 | NPI | - | NPPES |
| 000604469AI | Medicaid | GA | |
| 202G709158 | Other | GA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Georgia) | Primary |
Oconee Rehabilitation Services Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 446 Spring Street, Sparta, GA 31087 Phone: 706-444-9200 Fax: 706-444-9201 | |
Edge Of Hope Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1040 Pine Valley Rd, Sparta, GA 31087 Phone: 830-285-4538 |