NPIMap

Organization Active NPI

Easter Seals Southern Georgia Inc.

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Albany, GA
National Provider Identifier
1124085451
Registry record updated Jan 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
047-R-0011 Issued in GA
Legal business name
EASTER SEALS SOUTHERN GEORGIA INC.
Practice address
1906 Palmyra Rd
Albany, GA 31701-1575
Phone
(229) 439-7061
Fax
(229) 439-2824
NPI assigned
Apr 28, 2006
Last updated
Jan 24, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2021

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

Authorized official

Name
Matt Hatcher
Title
Coo
Phone
(229) 439-7061

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 047-R-0011 GA
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 047-R-0011 GA Primary
Durable Medical Equipment & Medical Supplies 332B00000X 047-R-0011 GA
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X 047-R-011 GA

Addresses

Primary practice location

1906 Palmyra Rd
Albany, GA 31701-1575

Mailing address

1906 Palmyra Rd
Albany, GA 31701-1575
Phone (229) 439-7061

National Provider Directory

National Provider Directory
Tax ID family
Easter Seals Southern Georgia Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611446400000",
    "number": "1124085451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 PALMYRA RD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011575",
            "telephone_number": "229-439-7061",
            "fax_number": "229-439-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 PALMYRA RD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011575",
            "telephone_number": "229-439-7061",
            "fax_number": "229-439-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTER SEALS SOUTHERN GEORGIA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2021-01-24",
        "certification_date": "2021-01-24",
        "status": "A",
        "authorized_official_last_name": "HATCHER",
        "authorized_official_first_name": "MATT",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "229-439-7061"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "GA",
            "license": "047-R-0011",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "047-R-0011",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "047-R-0011",
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "GA",
            "license": "047-R-011",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2021; 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.