MCINTOSH TRAIL CSB (NPI# 1477721397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477721397 |
| Entity Type | Organization |
| Organization Name | MCINTOSH TRAIL CSB |
| Practice Address |
1459 Williamson Road Griffin GA 30224-8428 |
| Mailing Address |
1501a Kalamazoo Dr Po Box 1320 Griffin GA 30224-3919 |
| Practice Telephone | 7703588514 |
| Mailing Telephone | 7703588250 |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2008-02-13 |
| Authorized Official Name | PAMELA MCCOLLUM (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7703588251 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811165483 | Mcintosh Trail Csb | Community/Behavioral Health | 1209 Greenbelt Dr, Griffin, GA 30224-4507 | 2008-02-15 |
| 1265600100 | Mcintosh Trail Csb | Community/Behavioral Health | 713 Andrews Dr, Thomaston, GA 30286-4524 | 2008-02-13 |
| 1174791016 | Mcintosh Trail Csb | Community/Behavioral Health | 514 W Poplar St, Griffin, GA 30224-2816 | 2008-02-13 |
| 1205004140 | Mcintosh Trail Csb | Community/Behavioral Health | 1343 W Poplar St, Griffin, GA 30224-2130 | 2008-02-13 |
| 1194993030 | Mcintosh Trail Csb | Community/Behavioral Health | 415 Ernest Biles Dr, Jackson, GA 30233-2282 | 2008-02-13 |
| 1801064746 | Mcintosh Trail Csb | Community/Behavioral Health | 672 Industrial Blvd, Mcdonough, GA 30253-6611 | 2008-02-13 |
| 1841478013 | Mcintosh Trail Csb | Community/Behavioral Health | 101 Owens Ln, Po Box E, Barnesville, GA 30204-1438 | 2008-02-09 |
| 1023296282 | Mcintosh Trail Csb | Community/Behavioral Health | 318 Burg Rd, Jenkinsburg, GA 30234-2001 | 2008-02-08 |
| 1689852840 | Mcintosh Trail Csb | Community/Behavioral Health | 715 Bradley Dr, Fayetteville, GA 30214-2030 | 2008-02-08 |
| 1750569919 | Mcintosh Trail Csb | Community/Behavioral Health | 160 Carnegie Pl, Fayetteville, GA 30214-3905 | 2008-02-08 |
| Street Address |
1459 WILLIAMSON ROAD |
| City | GRIFFIN |
| State | GA |
| Zip Code | 30224-8428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346888971 | Latamika Renee Williams | Counselor | 1710 Ga-16 West, #6, Griffin, GA 30224 | 2019-12-13 |
| 1063062651 | Dominique S Paul-thompson | Contractor | 112 Deercreek Parkway, Griffin, GA 30224 | 2019-09-16 |
| 1497303531 | Xiaohui Zhang Brotzge | Physician Assistant | 601 S 8th Street, Griffin, GA 30224 | 2019-09-02 |
| 1548812282 | Andrew Dennis Nesmith | Registered Nurse | 601 South 8th St, Emergency Room, Griffin, GA 30224 | 2019-07-12 |
| 1073009122 | Alicia Skye Ledford | Nurse Practitioner | 619 S 8th St., Suite 200, Griffin, GA 30224 | 2018-07-02 |
| 1649787102 | Judith Fuajong Ngulefac | Nurse Practitioner | 1705 Williamson Rd, Griffin, GA 30224 | 2018-01-05 |
| 1699297077 | Amanda Norman | Speech-Language Pathologist | 106 Garnet Ln, Griffin, GA 30224 | 2017-07-07 |
| 1306214655 | Ruchi P Gandhi | Optometrist | 646 8th Street, Griffin, GA 30224 | 2015-09-03 |
| 1528473881 | Nnenna Ezeilo | Otolaryngology | 619 S 8th St Ste 304, Griffin, GA 30224 | 2014-06-25 |
| 1437436094 | C. B. Reddy Md PC | Preferred Provider Organization | 610 S 8th Street, Suite F, Griffin, GA 30224 | 2011-11-10 |
| Find all providers in zip 30224 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487171351 | Remember Me Community Outreach, Inc. | Community/Behavioral Health | 1444 Meriwether St, Griffin, GA 30224-3989 | 2017-08-23 |
| 1093262503 | Renewing Hope LLC | Community/Behavioral Health | 2896 N Expressway Ste A, Griffin, GA 30223-7254 | 2016-09-01 |
| 1760801179 | Perfect Choice Private Home Care | Community/Behavioral Health | 1704 W Poplar St, Griffin, GA 30224-7102 | 2014-04-14 |
| 1942557491 | Choice Lab, Inc | Community/Behavioral Health | 221b W Poplar St, Griffin, GA 30224-3032 | 2012-08-14 |
| 1497070007 | Safer Ground Community Services, Inc. | Community/Behavioral Health | 315 W Solomon St, Suite 210, Griffin, GA 30223-3038 | 2010-04-07 |
| 1427225655 | Pathways Center for Behavioral and Developmental Growth | Community/Behavioral Health | 1710 Highway 16 W, Griffin, GA 30223-7107 | 2008-05-16 |
| 1871762252 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 1112 Broad Sreet, Griffin, GA 30223-2604 | 2008-02-29 |
| 1003085473 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 221 Laurel Street, Griffin, GA 30224-4731 | 2008-02-29 |
| 1699944074 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 13 Birnam Woods Road, Griffin, GA 30223-6684 | 2008-02-29 |
| 1952570335 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 318 North 3rd Street, Griffin, GA 30223-3354 | 2008-02-29 |
| Find all providers in GRIFFIN | ||||
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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.