Provider Demographics
NPI:1174896179
Name:NORTHWEST GEORGIA BAPTIST ASSOCIATION
Entity type:Organization
Organization Name:NORTHWEST GEORGIA BAPTIST ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF MISSIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN
Authorized Official - Phone:706-764-1941
Mailing Address - Street 1:63 PIN OAK DR
Mailing Address - Street 2:
Mailing Address - City:ROCK SPRING
Mailing Address - State:GA
Mailing Address - Zip Code:30739-2328
Mailing Address - Country:US
Mailing Address - Phone:706-764-1951
Mailing Address - Fax:706-764-1959
Practice Address - Street 1:63 PIN OAK DR
Practice Address - Street 2:
Practice Address - City:ROCK SPRING
Practice Address - State:GA
Practice Address - Zip Code:30739-2328
Practice Address - Country:US
Practice Address - Phone:706-764-1951
Practice Address - Fax:706-764-1959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-22
Last Update Date:2014-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health