NPIMap

Organization Active NPI

Community Service Board of East Central Georgia

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Hephzibah, GA
National Provider Identifier
1013474915
Registry record updated Feb 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
COMMUNITY SERVICE BOARD OF EAST CENTRAL GEORGIA
Practice address
1715 Lawerence Rd
Hephzibah, GA 30815-4445
Phone
(706) 432-4837
NPI assigned
Feb 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michele Prior
Title
Billing Supervisor
Phone
(706) 432-4837

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

1715 Lawerence Rd
Hephzibah, GA 30815-4445

Mailing address

3421 Mike Padgett Hwy
Augusta, GA 30906-3815

Other identifiers 1

IdentifierTypeStateIssuer
000605833ARMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
CSB of East Central Ga49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

Organizations that report the same tax identification number in the National Provider Directory.

View all 48

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1013474915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 MIKE PADGETT HWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309063815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 LAWERENCE RD",
            "city": "HEPHZIBAH",
            "state": "GA",
            "postal_code": "308154445",
            "telephone_number": "706-432-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SERVICE BOARD OF EAST CENTRAL GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-27",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "PRIOR",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "BILLING SUPERVISOR",
        "authorized_official_telephone_number": "706-432-4837"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000605833AR",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hephzibah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.