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).
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 |
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 |
Street Address |
2401 BUENA VISTA RD |
City | COLUMBUS |
State | GA |
Zip Code | 31906-3142 |
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 |
Find all providers in the same location |
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 |
Find all providers in zip 31906 |
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 |
---|---|---|---|---|
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 |
Find all providers in COLUMBUS |
Please comment or provide details below to improve the information on MENTAL RETARDATION WAIVER PROGRAM MUSCOGEE.
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.