Provider Demographics
NPI:1033428875
Name:CAMDEN C & A
Entity Type:Organization
Organization Name:CAMDEN C & A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DEO
Authorized Official - Prefix:
Authorized Official - First Name:GLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:912-449-7103
Mailing Address - Street 1:1007 MARY ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31503-3823
Mailing Address - Country:US
Mailing Address - Phone:912-449-7111
Mailing Address - Fax:912-449-7060
Practice Address - Street 1:100 MARINERS DR
Practice Address - Street 2:SUITE D
Practice Address - City:KINGSLAND
Practice Address - State:GA
Practice Address - Zip Code:31548-6666
Practice Address - Country:US
Practice Address - Phone:912-449-7111
Practice Address - Fax:912-449-7060
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SATILLA COMMUNITY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty