Charles E.kelly & Company

NPI #1184021347 in Claxton, Georgia

Provider Information

NPI Number: 1184021347
Entity Type: Organization
Organization Name: Charles E.kelly & Company
Subpart: Yes (part of a larger organization)
Parent Organization: GLENVILLE BANK
Primary Specialty: Preferred Provider Organization
Enumeration Date: Dec 3, 2014
Last Updated: Dec 3, 2014

Practice Location

Address: 409 OAK ST
City: Claxton
State: Georgia
ZIP Code: 30417-1351
Phone: (912) 739-1122

Authorized Official

Name: MR. CHARLES E KELLY SR., DOC
Title: MARKET COMMUNICATION SPECIALIST
Phone: (912) 739-1122

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Pastoral — Pastoral	101YP1600X
Case Management	251B00000X
Community/Behavioral Health	251S00000X
Preferred Provider Organization	305R00000X	Primary

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