| Community Service Board Of Middle Georgia | |
|
417 Louisiana Ave E Soperton GA 30457-1126 | |
| (478) 272-1190 | |
| (478) 274-7628 |
| Full Name | Community Service Board Of Middle Georgia |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 417 Louisiana Ave E, Soperton, Georgia |
| Authorized Official Name and Position | Cynthia Reid (CFO) |
| Authorized Official Contact | 4782721190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Service Board Of Middle Georgia 2121a Bellevue Rd Dublin GA 31021-2998 Ph: (478) 272-1190 | Community Service Board Of Middle Georgia 417 Louisiana Ave E Soperton GA 30457-1126 Ph: (478) 272-1190 |
| NPI Number | 1689707150 |
|---|---|
| Provider Enumeration Date | 03/14/2007 |
| Last Update Date | 07/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689707150 | NPI | - | NPPES |
| 000606284M | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Ubuntu Reloaded Coffee And Conversation Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1009 Second St Ste A, Soperton, GA 30457 Phone: 478-290-8453 |