CSB OF EAST CENTRAL GA (NPI# 1851622484) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851622484 |
| Entity Type | Organization |
| Organization Name | CSB OF EAST CENTRAL GA |
| Other Organization Name | HICKEY PCH |
| Practice Address |
1715 Forest Drive Augusta GA 30901 |
| Mailing Address |
3421 Mike Padgett Hwy Augusta GA 30906-3815 |
| Practice Telephone | 7064324858 |
| Practice Fax Number | 7064323780 |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2010-01-21 |
| Authorized Official Name | WANDA JESSIE (BILLING MANAGER) |
| Authorized Official Telephone | 7064324858 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000927693AH | 05 |
| Other Name | Type Code |
|---|---|
| HICKEY PCH | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467013821 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5101 Parnell Way, Martinez, GA 30907-8896 | 2019-06-26 |
| 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 |
| 1508305285 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3126 Richmond Hill Rd, Augusta, GA 30906-4754 | 2017-02-15 |
| 1447798707 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 355 Bobwhite Trl, Grovetown, GA 30813-5886 | 2017-02-07 |
| 1346565926 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3015 Manchester Dr, Hephzibah, GA 30815-7166 | 2010-04-07 |
| 1700101391 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2006 Country Place Dr, Augusta, GA 30906-8732 | 2010-04-07 |
| 1588995112 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 386 Tower Rd, Augusta, GA 30907-8750 | 2010-01-21 |
| 1881925410 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3461 Camak Dr, Augusta, GA 30909-9433 | 2010-01-21 |
| 1053642686 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2115 Ashley Dr, Augusta, GA 30906-5085 | 2010-01-21 |
| 1679804215 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2208 Walden Dr, Augusta, GA 30904-6508 | 2010-01-21 |
| Street Address |
1715 FOREST DRIVE |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477019925 | Courtney Erin Fairchild | Physician Assistant | 1101 15th Street, Pa-224, Augusta, GA 30901 | 2019-02-20 |
| 1699263921 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1022 Walton Way Spc C, Augusta, GA 30901 | 2018-04-23 |
| 1235684192 | Heather Raborn | Allergy & Immunology | 1350 Walton Way Ste 5100, Augusta, GA 30901 | 2016-08-22 |
| 1457690745 | Rehab Without Walls, Inc. | In Home Supportive Care | 820 St Sebastin Way Se, Augusta, GA 30901 | 2013-02-06 |
| 1861788051 | Christina Weidner Belcher | Physical Therapist | 1246 Pine St, Augusta, GA 30901 | 2011-06-25 |
| 1750695979 | C H Martin Company | Durable Medical Equipment & Medical Supplies | 1456 Walton Way Suite B, Augusta, GA 30901 | 2010-07-29 |
| 1366773905 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4027 Wheeler Rd, Augusta, GA 30901 | 2010-01-21 |
| 1760615280 | Absolute Family PCh | Point of Service | 2035 Old Savannah Rd., Augusta, GA 30901 | 2009-09-01 |
| 1073740643 | Ryan J Altenburg | Internal Medicine | 820 Saint Sebastian Way Ste 8a, Augusta, GA 30901 | 2009-06-22 |
| 1073700464 | Downtown Dental LLC | Dentist | 1162 Broad Street, Augusta, GA 30901 | 2007-09-28 |
| Find all providers in zip 30901 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942691431 | Vincent Roselli | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2416 Eagle Dr, Augusta, GA 30906-3325 | 2015-02-05 |
| 1861735391 | Beverly Briggs | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3520 Primrose Ct, Augusta, GA 30906-9576 | 2013-04-03 |
| 1821392572 | Renee's Personal Care Home, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1916 Ohio Ave, Augusta, GA 30904-5329 | 2011-01-10 |
| 1700101391 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2006 Country Place Dr, Augusta, GA 30906-8732 | 2010-04-07 |
| 1588995112 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 386 Tower Rd, Augusta, GA 30907-8750 | 2010-01-21 |
| 1881925410 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3461 Camak Dr, Augusta, GA 30909-9433 | 2010-01-21 |
| 1053642686 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2115 Ashley Dr, Augusta, GA 30906-5085 | 2010-01-21 |
| 1679804215 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2208 Walden Dr, Augusta, GA 30904-6508 | 2010-01-21 |
| 1790016327 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2110 Stevens Rd, Augusta, GA 30906-2058 | 2010-01-21 |
| 1437480035 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 313 S Belair Rd, Augusta, GA 30907-8835 | 2010-01-21 |
| Find all providers in AUGUSTA | ||||
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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.