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CSB of East Central Ga

Organization Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Augusta, GA

NPI 1114258654 · NPPES record last updated Jan 22, 2010

Key facts

NPI
1114258654
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Legal business name
CSB OF EAST CENTRAL GA
Practice address
3421 Mike Padgett Hwy
Augusta, GA 30906-3815
Phone
(706) 432-4858
NPI assigned
Jan 22, 2010
Organization subpart
No

Authorized official

Name
Wanda Jessie
Title
Billing Manager
Phone
(706) 432-4858

Corporate family (same tax ID) 48

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

View all 48

National Provider Directory

Tax ID family
CSB of East Central Ga (49 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X GA Yes

Addresses

Primary practice location

3421 Mike Padgett Hwy
Augusta, GA 30906-3815

Mailing address

3421 Mike Padgett Hwy
Augusta, GA 30906-3815

Other identifiers

IdentifierTypeStateIssuer
000605833LMedicaidGA

Other names

  • RICHMOND DD/TASC: COMP Doing business as

Other providers in Augusta, GA

All providers in Augusta, GA · Intellectual and/or Developmental Disabilities Residential Treatment Facility in Georgia

Sources for this page

Verify at the official NPI Registry.