COMMUNITY SERVICE BOARD OF EAST CENTRAL GEORGIA (NPI# 1013474915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013474915 |
| Entity Type | Organization |
| Organization Name | COMMUNITY SERVICE BOARD OF EAST CENTRAL GEORGIA |
| Practice Address |
1715 Lawerence Rd Hephzibah GA 30815-4445 |
| Mailing Address |
3421 Mike Padgett Hwy Augusta GA 30906-3815 |
| Practice Telephone | 7064324837 |
| Enumeration Date | 2019-02-27 |
| Last Update Date | 2019-02-27 |
| Authorized Official Name | MICHELE PRIOR (BILLING SUPERVISOR) |
| Authorized Official Telephone | 7064324837 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000605833AR | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164995965 | Community Service Board of East Central Georgia | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1908 Driftwood Dr, Augusta, GA 30909-4113 | 2019-01-04 |
| 1891203345 | Community Service Board of East Central Georgia | Counselor | 1253 Greene St, Augusta, GA 30901-2127 | 2018-01-18 |
| 1023516002 | Community Service Board of East Central Georgia | Community/Behavioral Health | 355 Bobwhite Trl, Grovetown, GA 30813-5886 | 2018-01-25 |
| 1649718057 | Community Service Board of East Central Georgia | Community/Behavioral Health | 3421 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2017-02-06 |
| Street Address |
1715 LAWERENCE RD |
| City | HEPHZIBAH |
| State | GA |
| Zip Code | 30815-4445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679091458 | Specialized Healthcare Services Inc | In Home Supportive Care | 2920 Tobacco Road, Suit A, Hephzibah, GA 30815 | 2017-08-31 |
| 1144747437 | Willie Mae Berry Pugh | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2013 Teal Court, Hephzibah, GA 30815 | 2017-08-28 |
| 1811448319 | Butterfly Gardens Hospice & Palliative Care | Hospice, Inpatient | 3112 Blackmon Court, Hephzibah, GA 30815 | 2016-10-19 |
| 1841651098 | Michelle Sherrie Coleman | Home Health Aide | 2708 Bob White Court, Hephzibah, GA 30815 | 2016-03-16 |
| 1285046409 | Allison Dionne Harden Bostic | Nurse's Aide | 1557 Brown Rd, Hephzibah, GA 30815 | 2014-05-22 |
| 1568802353 | Daryl Wolf | Chiropractor | 2742 Willis Foreman Rd., Hephzabah, GA 30815 | 2013-06-26 |
| 1336467547 | Gussie Holmes Lawson | Adult Companion | 2412 Orchard Dr., Hephzibah, GA 30815 | 2010-05-12 |
| 1275864811 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2232 Montcrief Drive, Hephzibah, GA 30815 | 2010-01-21 |
| 1376878801 | Freeman's Second Time Around Healthcare Services | Home Health | 2716 Castletown Dr, Hephzibah, GA 30815 | 2009-10-16 |
| 1205028545 | Tonia Lynn Manley | Licensed Practical Nurse | 38th Street Building 38707, Fort Gordon, GA 30815 | 2007-08-10 |
| Find all providers in zip 30815 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811436512 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4008 Ramswood Dr, Hephzibah, GA 30815-5849 | 2017-02-15 |
| 1053683672 | Americanwork, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2082 Brown Rd, Hephzibah, GA 30815-4401 | 2012-01-27 |
| 1417229030 | Americanwork, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2577 Anthony Dejuan Pkwy, Hephzibah, GA 30815-5932 | 2012-01-27 |
| 1568530798 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3533 Stafford St, Hephzibah, GA 30815-6625 | 2006-12-04 |
| 1629146311 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3518 Snowden Dr, Hephzibah, GA 30815-6631 | 2006-12-01 |
| 1912075904 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3004 Cromwell Ct, Hephzibah, GA 30815-6212 | 2006-11-30 |
| 1316015308 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2577 Lincolnton Pkwy, Hephzibah, GA 30815-5932 | 2006-11-30 |
| 1265509806 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4114 Pinnacle Pines Ct, Hephzibah, GA 30815-6137 | 2006-11-29 |
| 1881966406 | Americanwork, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3004 Cromwell Ct, Hephzibah, GA 30815-6212 | 2012-01-27 |
| 1558632968 | Americanwork, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3533 Stafford St, Hephzibah, GA 30815-6625 | 2012-01-17 |
| Find all providers in HEPHZIBAH | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.