South Georgia Csb

NPI #1578636817 in Valdosta, Georgia

Provider Information

NPI Number: 1578636817
Entity Type: Organization
Organization Name: South Georgia Csb
Primary Specialty: Residential Treatment Facility, Emotionally Disturbed Children
Enumeration Date: Nov 16, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 4401 WILLOW WOOD GATE
City: Valdosta
State: Georgia
ZIP Code: 31602-6709
Phone: (229) 242-4734

Authorized Official

Name: MRS. SUE GUPTON
Title: CHIEF EXECUTIVE OFFICER
Phone: (229) 245-2379

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X	Primary

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