Henry Dd Service Center

LBN: Mcintosh Trail Csb
Henry Dd Service Center is an health care organization with primary practice located at 672 Industrial Blvd , Mcdonough GA 30253-6611. The organization recently has only one registered license in Agencies / Community/Behavioral Health, which is considered as the primary health care specialty. Mcintosh Trail Csb can be contacted via phone (770) 358-8258, or through Hubbard, Mike via phone (770) 358-8251.

Contact Information

Primary practice address
672 Industrial Blvd Mcdonough GA 30253-6611
Phone: (770) 358-8258
Fax: (770) 229-3223
Website:
Map and Directions
Authorized official contact:
Name: Hubbard, Mike Licensed Clinical Social Worker (LCSW)
Phone: (770) 358-8251

Health care specialties

SpecialtyCodeLicense #State
Agencies / Community/Behavioral Health 251S00000X

Profile Details

NPI number 1801064746
LBN Legal business name Mcintosh Trail Csb
DBA Doing business as Henry Dd Service Center
Authorized official Hubbard, Mike Licensed Clinical Social Worker (LCSW)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 13th, 2008
Last updated Dec 17th, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801064746 NPPES
Georgia MEDICAID 000603435N
Georgia MEDICAID 000603435F

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