NPI 1578636817

South Georgia Csb

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Valdosta, GA

Practice location

Address: 4401 Willow Wood Gate, Valdosta, GA 31602-6709
Phone: (229) 242-4734
Fax: (229) 242-2984

Authorised official

Name: Sue Gupton
Title: Chief Executive Officer
Phone: (229) 245-2379

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Georgia →

Registry record

NPI: 1578636817
Entity type: Organization
NPI issued: 16 Nov 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.