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General NPI Number Information
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NPI Number | 1205209608
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Entity Type | Organization
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Legal Business Name | GOOD SAMARITAN CLINIC OF WASHINGTON COUNTY INC.
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Dates
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Enumeration Date | 11/06/2015
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Last Update Date | 03/24/2016
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Provider Practice Location Address
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Address Line | 2524 E ALEXANDER ST
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City | GREENVILLE
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State | MS
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Zip | 38703-3330
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Country | US
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Telephone | 662-347-3034
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 231
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-0231
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Country | US
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Telephone | 770-672-6400
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | LINDA ANDERSON
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Credential |
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Telephone | 662-347-3034
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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