NPIMap

Organization Active NPI

CSB Clubhouse

  • Community/Behavioral Health Agency
  • Dublin, GA
National Provider Identifier
1073996245
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CSB CLUBHOUSE
Practice address
1008 Hillcrest Pkwy
Dublin, GA 31021-4262
Phone
(478) 272-1190
Fax
(478) 274-7628
NPI assigned
Jul 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Authorized official

Name
Robert K Moran
Title
Cfo
Phone
(478) 272-1190

Specialties & licenses 1

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

Addresses

Primary practice location

1008 Hillcrest Pkwy
Dublin, GA 31021-4262

Mailing address

1008 Hillcrest Pkwy
Dublin, GA 31021-4262
Phone (478) 272-1190

Other identifiers 1

IdentifierTypeStateIssuer
300030912AMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Community Service Board of Middle Georgia30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

Locations

1008 Hillcrest Pkwy
Dublin, GA 31021
Phone (478) 272-1190

NPI Registry JSON

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

{
    "created_epoch": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436227200000",
    "number": "1073996245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 HILLCREST PKWY",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310214262",
            "telephone_number": "478-272-1190",
            "fax_number": "478-274-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 HILLCREST PKWY",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310214262",
            "telephone_number": "478-272-1190",
            "fax_number": "478-274-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSB CLUBHOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2015-07-07",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "478-272-1190"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300030912A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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.