Healthcare Provider Details

I. General information

NPI: 1962228528
Provider Name (Legal Business Name): OPTIONS CARE & SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2024
Last Update Date: 11/28/2024
Certification Date: 11/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 STONEWALL JACKSON PL
WAYCROSS GA
31503-9568
US

IV. Provider business mailing address

606 STONEWALL JACKSON PL
WAYCROSS GA
31503-9568
US

V. Phone/Fax

Practice location:
  • Phone: 706-326-2181
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name: MECHELE MCKENZIE, MS
Title or Position: OWNER
Credential: BCBA
Phone: 706-326-2181