Provider Demographics
NPI:1093784720
Name:MIDDLE FLINT AREA COMMUNITY SERVICE BOARD
Entity Type:Organization
Organization Name:MIDDLE FLINT AREA COMMUNITY SERVICE BOARD
Other - Org Name:MIDDLE FLINT BEHAVIORAL HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:UTILIZATION MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-815-5286
Mailing Address - Street 1:415 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:AMERICUS
Mailing Address - State:GA
Mailing Address - Zip Code:31709-3015
Mailing Address - Country:US
Mailing Address - Phone:229-931-2470
Mailing Address - Fax:229-931-2474
Practice Address - Street 1:415 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:AMERICUS
Practice Address - State:GA
Practice Address - Zip Code:31709-3015
Practice Address - Country:US
Practice Address - Phone:229-931-2470
Practice Address - Fax:229-931-2474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000607087DMedicaid
GA000604502BMedicaid
GA000603237KMedicaid
GA000604502AMedicaid
GA000603237BMedicaid
GA000607087HMedicaid
GA000603237AMedicaid
GA000603237HMedicaid
GA000607087LMedicaid
GA000921335BMedicaid
GA000603237FMedicaid
GA000607087AMedicaid
GA000607087EMedicaid
GA000603237DMedicaid
GA000603237JMedicaid
GA000603237MMedicaid
GA000603237PMedicaid
GA000607087GMedicaid
GA000701126BMedicaid
GA000701126CMedicaid
GA000921335CMedicaid