Healthcare Provider Details
I. General information
NPI: 1922205236
Provider Name (Legal Business Name): CAREPARTNERS OF GEORGIA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
432 N ROUNTREE ST
METTER GA
30439-3615
US
IV. Provider business mailing address
109 ROBERTS STREET
SWAINSBORO GA
30401-3114
US
V. Phone/Fax
- Phone: 478-237-2484
- Fax:
- Phone: 478-237-2484
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DAVID
W
CROOKE
Title or Position: CEO
Credential: LPC
Phone: 478-237-2484