| Southern Bridge Counseling, Llc | |
|
100 Shoshone Circle Kathleen GA 31047 | |
| (910) 689-5190 | |
| Not Available |
| Full Name | Southern Bridge Counseling, Llc |
|---|---|
| Speciality | Case Management |
| Location | 100 Shoshone Circle, Kathleen, Georgia |
| Authorized Official Name and Position | Darla Jackson (CO OWNER) |
| Authorized Official Contact | 9106895190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Bridge Counseling, Llc 100 Shoshone Circle Kathleen GA 31047 Ph: (910) 689-5190 | Southern Bridge Counseling, Llc 100 Shoshone Circle Kathleen GA 31047 Ph: (910) 689-5190 |
| NPI Number | 1326407453 |
|---|---|
| Provider Enumeration Date | 02/17/2016 |
| Last Update Date | 02/17/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326407453 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251B00000X | Case Management | (* (Not Available)) | Primary |
Affirmative Transformation Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 507 Amberley Ct, Kathleen, GA 31047 Phone: 478-227-6144 Fax: 866-554-5153 |