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General NPI Number Information
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NPI Number | 1346238276
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Entity Type | Organization
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Legal Business Name | JAMES B. CRAIG CENTER
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 200 ALLEN RD
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City | MILLEDGEVILLE
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State | GA
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Zip | 31062-7523
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Country | US
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Telephone | 478-445-5478
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Fax | 478-445-4251
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Provider Business Mailing Address
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Address Line | 200 ALLEN RD
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City | MILLEDGEVILLE
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State | GA
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Zip | 31062-7523
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Country | US
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Telephone | 478-445-5478
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Fax | 478-445-4251
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. WILLIAM K. GARLAND
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Credential | NHA
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Telephone | 478-445-5478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number | 1-005-1217
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License Number State | GA
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