Our Space Clubhouse

NPI 1225368640 - Social Worker - 1041C0700X

NPI Details
NPI 1225368640
Enumeration Date 01/07/2010
Last Updated 01/07/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name PERRY PERRY
Position CEO
Phone (229) 732-5050
Fax (229) 732-5058
Practice Location
644 BLAKELY ST
CUTHBERT GA, 39840-5325, US
Phone (229) 732-5050
Fax (229) 732-5058
Business Location
2100 COMER AVE
COLUMBUS GA, 31904-8725, US
Phone (706) 596-5583
Fax (706) 596-5589
Toxanomy
Taxonomy Code 1041C0700X
License State
License Number
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According to our database, Our Space Clubhouse NPI is 1225368640, taxonomy code is 1041C0700X Our Space Clubhouse physically located at 644 Blakely St, Cuthbert GA, 39840-5325. NPI Number 1033115704 has the healthcare provider type.

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1225368640 NPI number is provided on an as is basis without warranty of any kind. 1225368640 is maintained by the National Plan & Provider Enumeration System. The contents of Our Space Clubhouse are for informational purposes only.