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CSB of East Central Ga

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

NPI 1295066835 · NPPES record last updated Jan 21, 2010

Key facts

NPI
1295066835
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
4006 Ramswood Dr
Hephzibah, GA 30815-5849
Phone
(706) 432-4858
Fax
(706) 432-3780
NPI assigned
Jan 21, 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 Yes

Addresses

Primary practice location

4006 Ramswood Dr
Hephzibah, GA 30815-5849

Mailing address

3421 Mike Padgett Hwy
Augusta, GA 30906-3815

Other identifiers

IdentifierTypeStateIssuer
000927693AKMedicaidGA

Other names

  • GOLDEN PCH Doing business as

Other providers in Hephzibah, GA

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

Sources for this page

Verify at the official NPI Registry.