Provider Demographics
NPI:1356495790
Name:MACON CITIZENS FOR THE HANDICAPPED, INC
Entity Type:Organization
Organization Name:MACON CITIZENS FOR THE HANDICAPPED, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-524-5888
Mailing Address - Street 1:PO BOX 698
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28744-0698
Mailing Address - Country:US
Mailing Address - Phone:828-524-5888
Mailing Address - Fax:828-369-5758
Practice Address - Street 1:909 LAKE EMORY ROAD
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734
Practice Address - Country:US
Practice Address - Phone:828-524-5888
Practice Address - Fax:828-369-5758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-056-018251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408365Medicaid