Provider Demographics
NPI:1013422443
Name:HEART OF GEORGIA ALTAMAHA REGIONAL COMMISSION
Entity Type:Organization
Organization Name:HEART OF GEORGIA ALTAMAHA REGIONAL COMMISSION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-374-4771
Mailing Address - Street 1:5405 OAK ST
Mailing Address - Street 2:
Mailing Address - City:EASTMAN
Mailing Address - State:GA
Mailing Address - Zip Code:31023-6034
Mailing Address - Country:US
Mailing Address - Phone:478-374-4771
Mailing Address - Fax:478-374-0703
Practice Address - Street 1:5405 OAK ST
Practice Address - Street 2:
Practice Address - City:EASTMAN
Practice Address - State:GA
Practice Address - Zip Code:31023-6034
Practice Address - Country:US
Practice Address - Phone:478-374-4771
Practice Address - Fax:478-374-0703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2017-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management