Provider Demographics
NPI:1902220536
Name:JODE COUNSELING TRAINING AND TREATMENT SERVICES INC
Entity Type:Organization
Organization Name:JODE COUNSELING TRAINING AND TREATMENT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOJNANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-788-7400
Mailing Address - Street 1:3555 MERCER UNIVERSITY DR STE 101-6
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-4966
Mailing Address - Country:US
Mailing Address - Phone:478-471-2111
Mailing Address - Fax:
Practice Address - Street 1:3555 MERCER UNIVERSITY DR
Practice Address - Street 2:SUITE 1016
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-4940
Practice Address - Country:US
Practice Address - Phone:678-670-9688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005821251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health