NPIMap

Organization Active NPI

Community Service Board of Middle Georgia

  • Community/Behavioral Health Agency
  • Waynesboro, GA
National Provider Identifier
1033630355
Registry record updated Jun 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA
Practice address
762 Old Millen Hwy
Waynesboro, GA 30830-8808
Phone
(706) 437-6854
Fax
(706) 437-6851
NPI assigned
Jun 28, 2017
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Keith Moran
Title
Cfo
Phone
(478) 275-6811

Corporate family (same tax ID) 29

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

View all 29

National Provider Directory

National Provider Directory
Tax ID family
Community Service Board of Middle Georgia (30 organizations share this tax ID)

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

762 Old Millen Hwy
Waynesboro, GA 30830-8808

Mailing address

223 N Anderson Dr
Swainsboro, GA 30401-4440
Phone (478) 289-2683

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
000709288CMedicaidGA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 28, 2017.

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498608000000",
    "number": "1033630355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 N ANDERSON DR",
            "city": "SWAINSBORO",
            "state": "GA",
            "postal_code": "304014440",
            "telephone_number": "478-289-2683",
            "fax_number": "478-289-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "762 OLD MILLEN HWY",
            "city": "WAYNESBORO",
            "state": "GA",
            "postal_code": "308308808",
            "telephone_number": "706-437-6854",
            "fax_number": "706-437-6851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-28",
        "last_updated": "2017-06-28",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "478-275-6811"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000709288C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waynesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; 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.