SOUTH GEORGIA CSB (NPI# 1871667675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871667675 |
| Entity Type | Organization |
| Organization Name | SOUTH GEORGIA CSB |
| Other Organization Name | PROJECT LIGHT |
| Practice Address |
1108 S Patterson St Valdosta GA 31601-6348 |
| Practice Telephone | 2292456410 |
| Practice Fax Number | 2292936242 |
| Mailing Telephone | 2292456410 |
| Mailing Fax Number | 2292936242 |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. SUE GUPTON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2292452379 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Project Light | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053624585 | South Georgia Csb | Community Based Residential Treatment Facility, Mental Illness | 1209 N Toombs St, Valdosta, GA 31601-3931 | 2010-07-26 |
| 1386718187 | South Georgia Csb | Clinic/Center | 1644 E Park Ave, Valdosta, GA 31602-3413 | 2006-11-20 |
| 1730252479 | South Georgia Csb | Clinic/Center | 321 W Brantley, Lakeland, GA 31635 | 2006-11-17 |
| 1942374343 | South Georgia Csb | Clinic/Center | 340 Tifton Eldorado Road, Tifton, GA 31794 | 2006-11-17 |
| 1942374350 | South Georgia Csb | Clinic/Center | 203 Industrial Park Drive, Adel, GA 31620 | 2006-11-17 |
| 1154494359 | South Georgia Csb | Clinic/Center | 1200 Roundtree St, Quitman, GA 31643-3712 | 2006-11-16 |
| 1356414569 | South Georgia Csb | Clinic/Center | 391 County Farm Rd, Ashburn, GA 31714-3413 | 2006-11-16 |
| 1578636817 | South Georgia Csb | Residential Treatment Facility, Emotionally Disturbed Children | 4401 Willow Wood Gate, Valdosta, GA 31602-6709 | 2006-11-16 |
| 1407929730 | South Georgia Csb | Clinic/Center | 252 N Saint Augustine Rd, Valdosta, GA 31601-5274 | 2006-11-16 |
| 1558457655 | South Georgia Csb | Community/Behavioral Health | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2006-10-05 |
| Street Address |
1108 S PATTERSON ST |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31601-6348 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437700838 | Tristan Carlos Garcia | Specialist/Technologist | 605 West Mary Street, Valdosta, GA 31601 | 2019-09-26 |
| 1508332438 | Euniqua Lashay Williams | Contractor | 812 Lausanne Drive, Valdosta, GA 31601 | 2018-10-18 |
| 1457847634 | Valencia Meshay Johnson | Contractor | 1211 North Oak Street, Valdosta, GA 31601 | 2018-07-10 |
| 1376038042 | Restoration Care Services, LLC | Home Health | 704 Lake Park Road, Valdosta, GA 31601 | 2018-06-26 |
| 1609373133 | Ikea Sharnay Calhoun | Contractor | 1710 Dedo Drive, Valdosta, GA 31601 | 2018-04-11 |
| 1174049431 | Alexious Denson | Contractor | 900 Blanton St., Apt A16, Valdosta, GA 31601 | 2017-08-18 |
| 1578012258 | Clarissa Yolanda Alderman | Counselor | 4107 N Forrest Run Circle, Valdosta, GA 31601 | 2016-09-23 |
| 1225322613 | Andrea J. Ramirez | Counselor | 1301 Melody Ln Ste B, Valdosta, GA 31601 | 2011-06-03 |
| 1316248560 | L&r Personal Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14 Sharper Circle, Valdosta, GU 31601 | 2010-11-04 |
| 1902121809 | Grace Healthcare Services Inc | Respite Care | 1010 Slater Street, Valdosta, GA 31601 | 2010-04-02 |
| Find all providers in zip 31601 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184844565 | Redirect Counseling Services Inc | Clinic/Center | 2031 Bemiss Rd # A, Valdosta, GA 31602-3030 | 2007-04-26 |
| 1144394941 | Behavioral Health Services of South Georgia | Clinic/Center | 3120 N Oak Street Ext Ste B, Valdosta, GA 31602-5910 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497217715 | Peachtree Recovery Centers, LLC | Clinic/Center | 3975 Roswell Rd Ne Ste 104, Atlanta, GA 30342-4119 | 2019-04-04 |
| 1902374812 | Centered Recovery Programs, LLC | Clinic/Center | 1000 Piedmont Rd, Marietta, GA 30066-4032 | 2018-11-08 |
| 1255816302 | Brainscience Recovery.works | Clinic/Center | 4233 Pleasant Hill Rd Ste 110, Duluth, GA 30096-1609 | 2018-09-25 |
| 1619469665 | First Georgia Counseling Services LLC | Clinic/Center | 921 W Taylor St, Griffin, GA 30223-2605 | 2018-06-05 |
| 1952899775 | Manifest Recovery | Clinic/Center | 1215 Hightower Trl Ste 201, Sandy Springs, GA 30350-6244 | 2018-04-26 |
| 1003317538 | East Point Recovery Center | Clinic/Center | 100 Governors Trce Ste 110, Peachtree City, GA 30269-4853 | 2018-02-21 |
| 1538671011 | Summit Wellness Group, Inc | Clinic/Center | 745 Hembree Pl, Roswell, GA 30076-4035 | 2017-10-24 |
| 1891214375 | Centered Recovery Programs, LLC | Clinic/Center | 1250 Upper Hembree Rd Ste E, Roswell, GA 30076-4651 | 2017-09-15 |
| 1386009520 | Georgia Detox and Recovery, LLC | Clinic/Center | 2812 Hillcreek Dr Ste B, Augusta, GA 30909-5632 | 2015-12-15 |
| 1427424183 | Trek Medical, LLC | Clinic/Center | 5895 Windward Parkway, Suite 150, Alpharetta, GA 30005 | 2015-08-18 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOUTH GEORGIA CSB.
| 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.