Dr Kenneith Durden Outreach

LBN: Dr Kenneith Durden Outreach
Dr Kenneith Durden Outreach is an health care organization with primary practice located at 41 Moonlight Trl , Port Wentworth GA 31407-3321. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as the primary health care specialty. Dr Kenneith Durden Outreach can be contacted via phone (404) 909-2442, or through Durden, Kenneith via phone (404) 909-2442.

Contact Information

Primary practice address
41 Moonlight Trl Port Wentworth GA 31407-3321
Phone: (404) 909-2442
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Durden, Kenneith
Phone: (404) 909-2442

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X

Profile Details

NPI number 1699120410
LBN Legal business name Dr Kenneith Durden Outreach
DBA Doing business as
Authorized official Durden, Kenneith
Entity Organization
Organization subpart 1 No
Enumeration date Apr 29th, 2016
Last updated Apr 29th, 2016 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1699120410 NPPES
Georgia MEDICAID 803411511B

Popular Providers