HIGHLAND RIVERS CENTER, CSB (NPI# 1881758613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881758613 |
| Entity Type | Organization |
| Organization Name | HIGHLAND RIVERS CENTER, CSB |
| Other Organization Name | HIGHLAND RIVERS LIGHTHOUSE |
| Practice Address |
1705 Dean Ave Se Rome GA 30161-7105 |
| Mailing Address |
1401 Burleyson Dr Suite 1 Dalton GA 30720-2522 |
| Practice Telephone | 7068025870 |
| Practice Fax Number | 7068020654 |
| Mailing Telephone | 7062705002 |
| Mailing Fax Number | 7063707749 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | KLAY WEAVER (CEO) |
| Authorized Official Telephone | 7062705000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | GA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | ORGANIZATION MASTER NPI | 1447256243 | 01 |
| Other Name | Type Code |
|---|---|
| HIGHLAND RIVERS LIGHTHOUSE | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285798041 | Highland Rivers Center, Csb | Community/Behavioral Health | 1709 Dean Ave Se, Rome, GA 30161-7105 | 2006-12-19 |
| 1255494365 | Highland Rivers Center, Csb | Durable Medical Equipment & Medical Supplies | 1710 Whitehouse Dr, Suite 200, Dalton, GA 30720-8523 | 2006-12-19 |
| 1336437763 | Highland Rivers Center, Csb | Community/Behavioral Health | 1 Woodbine Ave Nw, Nw, Rome, GA 30165-2397 | 2011-07-19 |
| 1396809620 | Highland Rivers Center, Csb | Respite Care | 1710 Whitehouse Dr, Suite 200, Dalton, GA 30720-8523 | 2006-12-21 |
| 1093879827 | Highland Rivers Center, Csb | Community/Behavioral Health | 18090 Highway 515 N, Ellijay, GA 30536-1331 | 2006-12-19 |
| 1174686620 | Highland Rivers Center, Csb | Community/Behavioral Health | 1305 Redmond Cir Nw, House # 1114, Rome, GA 30165-1345 | 2006-12-18 |
| Street Address |
1705 DEAN AVE SE |
| City | ROME |
| State | GA |
| Zip Code | 30161-7105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407025216 | Janine Marie Wanke | Social Worker | 1705 Dean Ave Se, Rome, GA 30161-7105 | 2008-02-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265069256 | Three Rivers Housing and Development Corporation | Chore Provider | 326 W. 9th St, Rome, GA 30161 | 2020-03-27 |
| 1144865957 | Eric Alan Fuller | Audiologist-Hearing Aid Fitter | 700 East 2nd Street, Suite C, Rome, GA 30161 | 2019-11-15 |
| 1003394883 | Cindy V Shelton | Health Educator | 204 E 1st Ave, Rome, GA 30161 | 2018-08-02 |
| 1083153597 | Julie Oglesby Allen | Counselor | 1 S Broad St Sw Ste 5, Rome, GA 30161 | 2017-02-16 |
| 1902299530 | Michael Thomas Phillips | Pharmacist | 2005 Maple Street, Rome, GA 30161 | 2015-03-06 |
| 1407259112 | Angela Smith | Community/Behavioral Health | 109 John Maddox Suite 200, Rome, GA 30161 | 2014-10-08 |
| 1215344379 | Nancy Patel | Pharmacist | 1421 North Broad St, Rome, GA 30161 | 2014-07-21 |
| 1821336629 | Wendy Pence | Nurse Practitioner | 3001 Turner Mccall Blvd, Rome, GA 30161 | 2013-01-29 |
| 1558526202 | Marilyn Teresa Ringstaff | Registered Nurse | 1513 Dean St., Rome, GA 30161 | 2008-07-22 |
| 1134310147 | Reneka L Dobbs-jackson | Family Medicine | 420 E 2nd Ave Ste 103, Rome, GA 30161 | 2007-08-05 |
| Find all providers in zip 30161 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407259112 | Angela Smith | Community/Behavioral Health | 109 John Maddox Suite 200, Rome, GA 30161 | 2014-10-08 |
| 1578994026 | J Keith Fricks Counseling LLC | Community/Behavioral Health | 10 E Creekview Dr Sw, Rome, GA 30165-3805 | 2013-12-10 |
| 1770829103 | Highland Rivers Community Service Board | Community/Behavioral Health | 7 Crosscreek Dr Nw, Rome, GA 30165-1202 | 2012-12-12 |
| 1598018491 | Highland Rivers Community Service Board | Community/Behavioral Health | 4 Glenda Dr Sw, Rome, GA 30165-3622 | 2012-10-17 |
| 1104179001 | Highland Rivers Community Service Board | Community/Behavioral Health | 4 East 10th Street, Rome, GA 30161-6164 | 2012-10-17 |
| 1295088193 | Highland Rivers Community Service Board | Community/Behavioral Health | 112 Rising Fawn Trl Ne, Rome, GA 30165-8675 | 2012-10-17 |
| 1982957965 | Highland Rivers Community Service Board | Community/Behavioral Health | 210 Coney Circle, Rome, GA 30161-0000 | 2012-10-16 |
| 1871845867 | Highland Rivers Community Service Board | Community/Behavioral Health | 382 Collier Rd Ne, Rome, GA 30165-8003 | 2012-10-15 |
| 1235481227 | Highland Rivers Community Service Board | Community/Behavioral Health | 104 Harrison Rd Nw, Rome, GA 30165-1016 | 2012-10-15 |
| 1316299670 | Highland Rivers Community Service Board | Community/Behavioral Health | 90 Gore Dr, Rome, GA 30161-1998 | 2012-10-11 |
| Find all providers in ROME | ||||
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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.