NPIMap

Organization Active NPI

Community Service Board of Middle Georgia

  • Community/Behavioral Health Agency
  • Eastman, GA
National Provider Identifier
1164555744
Registry record updated Aug 22, 2020
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
621 Plaza Ave
Eastman, GA 31023-6753
Phone
(478) 448-1040
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Robert Keith Moran
Title
Cfo
Phone
(478) 272-1190

Specialties & licenses 1

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

Addresses

Primary practice location

621 Plaza Ave
Eastman, GA 31023-6753

Mailing address

621 Plaza Ave
Eastman, GA 31023-6753

Other names 1

  • Eastman Clinic Doing business as

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

621 Plaza Ave
Eastman, GA 31023
Phone (478) 448-1040

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164555744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 PLAZA AVE",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 PLAZA AVE",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "310236753",
            "telephone_number": "478-448-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "478-272-1190",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastman Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eastman, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.