Provider Demographics
NPI:1881369403
Name:ALZHEIMER'S OUTREACH CENTER OF SOUTH GEORGIA
Entity type:Organization
Organization Name:ALZHEIMER'S OUTREACH CENTER OF SOUTH GEORGIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:F
Authorized Official - Last Name:GOODE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-886-1177
Mailing Address - Street 1:229 N JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31701-2518
Mailing Address - Country:US
Mailing Address - Phone:229-432-2705
Mailing Address - Fax:229-496-1240
Practice Address - Street 1:229 N JACKSON ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-2518
Practice Address - Country:US
Practice Address - Phone:229-432-2705
Practice Address - Fax:229-496-1240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health