MENTAL RETARDATION WAIVER PROGRAM MUSCOGEE


Address: 2401 Buena Vista Rd, Columbus, GA 31906-3142
Phone: 7065965583

MENTAL RETARDATION WAIVER PROGRAM MUSCOGEE (NPI# 1750576807) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1750576807
Entity Type Organization
Organization Name MENTAL RETARDATION WAIVER PROGRAM MUSCOGEE
Practice Address 2401 Buena Vista Rd
Columbus
GA 31906-3142
Mailing Address 2100 Comer Ave
Columbus
GA 31904-8725
Practice Telephone 7065965583
Practice Fax Number 7065965589
Mailing Telephone 7063271541
Enumeration Date 2007-09-12
Last Update Date 2007-09-12
Authorized Official Name PERRY ALEXANDER (CEO)
Authorized Official Telephone 7065965582
Is Organization Subpart Y
Parent Organization Name NEW HORIZONS COMMUNITY BOARD

Taxonomy

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

Office Location

Street Address 2401 BUENA VISTA RD
City COLUMBUS
State GA
Zip Code 31906-3142

Providers in the same location

NPI Name Taxonomy Address Enumeration
1457987711 Justin Stafford Community Health Worker 2401 Buena Vista Rd, Columbus, GA 31906-3142 2020-03-19
1477189918 Shabriel Willis Day Training, Developmentally Disabled Services 2401 Buena Vista Rd, Columbus, GA 31906-3142 2020-03-17
1306488903 Justin Ormond Harper Day Training, Developmentally Disabled Services 2401 Buena Vista Rd, Columbus, GA 31906-3142 2019-10-15
1053953653 Latoya Williams Day Training, Developmentally Disabled Services 2401 Buena Vista Rd, Columbus, GA 31906-3142 2019-10-15
1629532676 Terrence Christie Day Training, Developmentally Disabled Services 2401 Buena Vista Rd, Columbus, GA 31906-3142 2019-01-24
1013485408 Gregory Lewis Day Training, Developmentally Disabled Services 2401 Buena Vista Rd, Columbus, GA 31906-3142 2018-11-05
1538652706 Curtis Bernard Thomas Day Training, Developmentally Disabled Services 2401 Buena Vista Rd, Columbus, GA 31906-3142 2018-06-12
1114433547 Adrian Lamar Zimon Day Training, Developmentally Disabled Services 2401 Buena Vista Rd, Columbus, GA 31906-3142 2017-12-21
1386150712 Derrick Gause Day Training, Developmentally Disabled Services 2401 Buena Vista Rd, Columbus, GA 31906-3142 2017-12-21
1780108274 Dennis Lewis Wright Community Health Worker 2401 Buena Vista Rd, Columbus, GA 31906-3142 2017-07-27
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1548778939 Kamisha Latonya Byrd Jr. Home Health 901joy Rd Lot B1, Columbus, GA 31906 2018-01-19
1093180234 Conchetta Perry Nurse Practitioner 1711 Buena Vista Road Suite #2, Columbus, GA 31906 2015-12-13
1972910586 Felicia Murphy Nurse's Aide 5619 Teresa, Columbus, GA 31906 2014-07-15
1932526340 Waytika Glover Community Health Worker 1719 Shepard Dr, Columbus, GA 31906 2014-03-24
1376973941 Laura Kaye Thomas Counselor 2100 Cormer Ave, Columbus, GA 31906 2013-11-19
1831528876 Mosco Davis In Home Supportive Care 2202 Francis St.., Columbus, GA 31906 2013-11-08
1104153451 Project Rebound Inc. Social Worker 1170 Brown Ave Street B, Columbus, GA 31906 2009-11-06
1982865499 Cheryl Denise Freeman-jackson Dentist 2206 Francis St, Columbus, GA 31906 2008-06-18
1366652083 Leroy Livingstone Boatswain Social Worker 919 Lawyers Lane, Columbus, GA 31906 2007-05-23
1023127222 Chikkanayak B Lokesh Psychiatry & Neurology 1310 13 Th Avenue, Va Cboc Clinic, Columbus, GA 31906 2006-08-30
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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1629680418 Catapillars To Butterflies, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 5900 Sharon Woods Blvd Ste D, Columbus, OH 43229-2600 2020-08-21
1720559420 Secure Haven Care, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 4295 Braunton Rd, Columbus, OH 43220-4301 2018-12-06
1851882617 Cg-hhc, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 200 Civic Center Dr Ste 1200, Columbus, OH 43215-4234 2018-05-28
1659882256 Heinzerling Foundation Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1605 Heinzerling Drive, Columbus, OH 43223 2017-10-23
1679084271 Heinzerling Foundation Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1625 Heinzerling Drive, Columbus, OH 43223 2017-10-23
1902286693 Advoserv of New Jersey, Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1182 Hedding Rd, Columbus, NJ 08022 2015-06-08
1356658918 Jireh Services, Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 3509 Refugee Rd, Columbus, OH 43232-4830 2010-09-02
1902077258 Viaquest Healthcare Central Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 5314 Redwood Rd, Columbus, OH 43229-4441 2008-03-14
1851507180 Heinzerling Developmental Center Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1755 Heinzerling Dr, Columbus, OH 43223-3672 2007-05-15
1053524660 Heinzerling Memorial Foundation Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1800 Heinzerling Dr, Columbus, OH 43223-3642 2007-05-08
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Competitor

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City COLUMBUS
Zip Code 31906

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Dataset Information

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.

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