HIGHLAND RIVERS COMMUNITY SERVICE BOARD (NPI# 1538442207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538442207 |
| Entity Type | Organization |
| Organization Name | HIGHLAND RIVERS COMMUNITY SERVICE BOARD |
| Practice Address |
1 Woodbine Ave Nw Rome GA 30165-2397 |
| Mailing Address |
1401 Applewood Dr Suite 1 Dalton GA 30720-2699 |
| Practice Telephone | 7063140019 |
| Practice Fax Number | 7063140343 |
| Mailing Telephone | 7062705002 |
| Mailing Fax Number | 7062705111 |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2012-04-03 |
| Authorized Official Name | MR. JASON BEARDEN (CEO) |
| Authorized Official Telephone | 7062705000 |
| Is Organization Subpart | Y |
| Parent Organization Name | HIGHLAND RIVERS COMMUNITY SERVICE BOARD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251C00000X | Day Training, Developmentally Disabled Services | GA | Agencies | |
| N | 251S00000X | Community/Behavioral Health | GA | Agencies | |
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
GA | Suppliers | |
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | GA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000601807AB | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144560491 | Highland Rivers Community Service Board | Community/Behavioral Health | 395 April Ln, Blue Ridge, GA 30513-4316 | 2013-02-25 |
| 1518205046 | Highland Rivers Community Service Board | Community/Behavioral Health | 75 Parksbrook Rd, Ellijay, GA 30540-7477 | 2013-01-17 |
| 1568708741 | Highland Rivers Community Service Board | Community/Behavioral Health | 167 Wild Rose Dr, Chatsworth, GA 30705-3197 | 2012-12-17 |
| 1770829103 | Highland Rivers Community Service Board | Community/Behavioral Health | 7 Crosscreek Dr Nw, Rome, GA 30165-1202 | 2012-12-12 |
| 1003160284 | Highland Rivers Community Service Board | Community/Behavioral Health | 2133 Old Federal Rd S, Chatsworth, GA 30705-4701 | 2012-11-09 |
| 1912250820 | Highland Rivers Community Service Board | Community/Behavioral Health | 123 Lewis St, Summerville, GA 30747-1260 | 2012-10-17 |
| 1629321526 | Highland Rivers Community Service Board | Community/Behavioral Health | 227 Broad St, Tallapoosa, GA 30176-1128 | 2012-10-17 |
| 1427301324 | Highland Rivers Community Service Board | Community/Behavioral Health | 32 Arnold Ln, Hiram, GA 30141-3900 | 2012-10-17 |
| 1518210418 | Highland Rivers Community Service Board | Community/Behavioral Health | 268 Canaan Rd, Ellijay, GA 30540-0849 | 2012-10-17 |
| 1598018491 | Highland Rivers Community Service Board | Community/Behavioral Health | 4 Glenda Dr Sw, Rome, GA 30165-3622 | 2012-10-17 |
| Street Address |
1 WOODBINE AVE NW |
| City | ROME |
| State | GA |
| Zip Code | 30165-2397 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063498913 | Joseph K Seal | Psychiatry & Neurology | 1 Woodbine Ave Nw, Rome, GA 30165-2397 | 2005-12-21 |
| 1750830568 | Calli Cruz | Marriage & Family Therapist | 1 Woodbine Ave Nw, Rome, GA 30165-2397 | 2016-09-22 |
| 1164874814 | Martha Wade | Case Manager/Care Coordinator | 1 Woodbine Ave Nw, Rome, GA 30165-2397 | 2016-07-06 |
| 1689039083 | Kimberlee Hill | Registered Nurse | 1 Woodbine Ave Nw, Rome, GA 30165-2397 | 2015-12-29 |
| 1770948572 | Pamela Martin | Counselor | 1 Woodbine Ave Nw, Rome, GA 30165-2397 | 2015-12-21 |
| 1437524832 | Tommy Brooks | Registered Nurse | 1 Woodbine Ave Nw, Rome, GA 30165-2397 | 2015-12-10 |
| 1245604552 | Scott Lindsay Garrison | Counselor | 1 Woodbine Ave Nw, Rome, GA 30165-2397 | 2015-11-24 |
| 1528454410 | Jeffrey Davis | Registered Nurse | 1 Woodbine Ave Nw, Rome, GA 30165-2397 | 2015-04-08 |
| 1841684024 | Sherry Lindsey | Registered Nurse | 1 Woodbine Ave Nw, Rome, GA 30165-2397 | 2015-03-25 |
| 1215321799 | Ashley Sellers | Registered Nurse | 1 Woodbine Ave Nw, Rome, GA 30165-2397 | 2015-03-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346868775 | Heather Bowman | Physical Therapist | 600 Eagle, E Lake Dr, Rome, GA 30165 | 2020-07-13 |
| 1205451101 | Kristopher Nelson | Student in an Organized Health Care Education/Training Program | 4256, 304 Shorter Ave Nw #201, Rome, GA 30165 | 2020-06-16 |
| 1962061457 | Stuart Paul Shaklee | Occupational Therapy Assistant | 1356 Redmond Road, Rome, GA 30165 | 2019-06-10 |
| 1386001055 | Autumn Streetman | Counselor | 6 Mathis Drive, Rome, GA 30165 | 2016-01-26 |
| 1144695784 | Gabrador Milligan | Counselor | 6 Mathis Road, Rome, GA 30165 | 2015-12-08 |
| 1386041952 | Theresa Suits | Registered Nurse | 1 Woodbine Avenue, Rome, GA 30165 | 2014-11-26 |
| 1942561147 | Nicole C. Christian | Clinical Neuropsychologist | 305 Redmond Rd, Rome, GA 30165 | 2012-06-04 |
| 1679832711 | Niki Pareshkumar Bhavsar | Internal Medicine | 3041 Turner Mccall Blvd, Rome, GA 30165 | 2012-05-10 |
| 1285927491 | Amanda Fischer Reeves | Family Medicine | 304 Shorter Ave Nw Ste 102, Rome, GA 30165 | 2011-05-20 |
| 1033436647 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 4 Coosawattee Ave, Rome, GA 30165 | 2010-04-23 |
| Find all providers in zip 30165 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417561747 | Georgia Regional Health LLC | Community Based Residential Treatment Facility, Mental Illness | 1211 Waterville Ct, Alpharetta, GA 30022-5381 | 2020-09-03 |
| 1275161192 | Monte Nido Georgia LLC | Community Based Residential Treatment Facility, Mental Illness | 124 Johnson Ferry Rd Ne, Sandy Springs, GA 30328-3004 | 2020-03-27 |
| 1811464035 | Hope Homes Recovery, LLC | Community Based Residential Treatment Facility, Mental Illness | 432 Virginia Rd, Atlanta, GA 30338-4793 | 2018-10-25 |
| 1770066029 | New Beginnings PCh of Columbus, LLC | Community Based Residential Treatment Facility, Mental Illness | 639 Lawyers Ln, Columbus, GA 31906-3812 | 2018-09-12 |
| 1588140859 | Butterfly Development, LLC | Community Based Residential Treatment Facility, Mental Illness | 1911 Grayson Highway, Suite 8-242, Grayson, GA 30017 | 2018-07-19 |
| 1326555210 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 101, Riverdale, GA 30274-1502 | 2018-01-02 |
| 1245747138 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 104, Riverdale, GA 30274-1502 | 2018-01-02 |
| 1235646217 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 401, Riverdale, GA 30274-1502 | 2017-12-29 |
| 1528574431 | House of Concrete Roses, LLC | Community Based Residential Treatment Facility, Mental Illness | 1133 Huff Rd Nw Apt 766, Atlanta, GA 30318-4327 | 2017-12-15 |
| 1508391756 | Mister Life Coach | Community Based Residential Treatment Facility, Mental Illness | 3681 N Decatur Rd Apt R11, Decatur, GA 30032-1062 | 2017-04-25 |
| Find all providers with the same taxonomy | ||||
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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.