SOUTHEAST GEORGIA TREATMENT CENTER NPI 1952931164

NPI Information

NPI: 1952931164
Provider Name: SOUTHEAST GEORGIA TREATMENT CENTER
Classification: Clinic/Center - 261QM2800X
Entity Type: Organization

Specialization: Methadone

CLIA Number: 11D2167513

Address:
816 PROFESSIONAL CENTER DR
EASTMAN, GA
ZIP 31023
Phone: (478) 374-0390
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SOUTHEAST GEORGIA TREATMENT CENTER is a methadone clinic center in Eastman, GA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. SOUTHEAST GEORGIA TREATMENT CENTER NPI is 1952931164. The provider is registered as an organization entity type.

The provider's business location address is:

816 PROFESSIONAL CENTER DR
EASTMAN, GA
ZIP 31023-734
Phone: (478) 374-0390

The provider's authorized official is Thomas M Knight .
The authorized official title is Manger and has the following contact phone number (478) 231-4728.

The CLIA number assigned to this NPI record is 11D2167513 - other - immediate care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/16/2020 and was last updated on 1/16/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM2800X	Clinic/Center	Methadone			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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