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NPI Code Detail

MEDICARE: AMERICANWORK, INC.

MEDICARE: AMERICANWORK, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1320900000XIntellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityCLA000684 PGA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417229030
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMERICANWORK, INC.
Provider Business Mailing Address
First Line : PO BOX 20664
Second Line :
City : ST SIMONS ISLAND
State : GA
Zip : 31522-0264
Country : US
Telephone Number : 912-638-0350
Fax Number : 912-638-9030
Provider Business Practice Location Address
First Line : 2577 ANTHONY DEJUAN PKWY
Second Line :
City : HEPHZIBAH
State : GA
Zip : 30815-5932
Country : US
Telephone Number : 706-772-6109
Fax Number :
Authorized Official
Title or Position : COO
Name : WILLIAM KENNETH WHIDDON
Credential :
Telephone Number : 912-638-0350
Provider Enumeration Date : 01/27/2012
Last Update Date : 01/27/2012

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