Provider Demographics
NPI:1851770325
Name:MACON CITIZENS HABILITIES, INC.
Entity Type:Organization
Organization Name:MACON CITIZENS HABILITIES, INC.
Other - Org Name:MACON CITIZENS ENTERPRISES
Other - Org Type:Other Name
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
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 1:913 LAKE EMORY RD
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:2015-05-29
Last Update Date:2015-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL056018251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health