Mitchell Baker Service Center

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

MITCHELL BAKER SERVICE CENTER

Practice address

65 Industrial Blvd
Camilla, GA 31730-3912

Phone

(229) 336-7977

Fax

(229) 336-1346

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Terri B. Johnson

Title

Billing Clerk II

Phone

(229) 336-7977

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1114043403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 INDUSTRIAL BLVD",
            "city": "CAMILLA",
            "state": "GA",
            "postal_code": "317303912",
            "telephone_number": "229-336-7977",
            "fax_number": "229-336-1346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 INDUSTRIAL BLVD",
            "city": "CAMILLA",
            "state": "GA",
            "postal_code": "317303912",
            "telephone_number": "229-336-7977",
            "fax_number": "229-336-1346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL BAKER SERVICE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TERRI",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "BILLING CLERK II",
        "authorized_official_telephone_number": "229-336-7977"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000649151A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Charles McGalliard, RPH
• Antonio Miller, RN
• Develle Miller
• Kristie Miller
• Elizabeth Morgan Millsaps, RPH, PHARM D
• Mitchell County Board of Education
• Mitchell County Board of Healtth
• Mitchell County EMS
• Mitchell County Hospital
• Mitchell County Pediatrics and Health Center

• Developmentally Disabled Services Day Training Agency in Camilla, GA
• Providers in Camilla, GA by specialty
• Developmentally Disabled Services Day Training Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.