NPIMap

Organization Active NPI

McIntosh Trail CSB

  • Community/Behavioral Health Agency
  • Griffin, GA
National Provider Identifier
1316115256
Registry record updated Feb 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MCINTOSH TRAIL CSB
Practice address
1459 Williamson Rd
Griffin, GA 30224-8428
Phone
(770) 229-3158
NPI assigned
Feb 13, 2008
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Pamela McCollum
Title
Executive Director
Phone
(770) 358-8251

Corporate family (same tax ID) 28

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

View all 28

National Provider Directory

National Provider Directory
Tax ID family
McIntosh Trail CSB (29 organizations share this tax ID)

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

1459 Williamson Rd
Griffin, GA 30224-8428

Mailing address

1501A Kalamazoo Dr
Griffin, GA 30224-3919
Phone (770) 358-8250

Other names 1

NPPES NPI Registry
  • McIntosh Trail SA CSB Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 13, 2008.

{
    "created_epoch": "1202860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202860800000",
    "number": "1316115256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501A KALAMAZOO DR",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302243919",
            "telephone_number": "770-358-8250",
            "fax_number": "770-229-3223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 WILLIAMSON RD",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302248428",
            "telephone_number": "770-229-3158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCINTOSH TRAIL CSB",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-13",
        "last_updated": "2008-02-13",
        "status": "A",
        "authorized_official_last_name": "MCCOLLUM",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "770-358-8251"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "McIntosh Trail SA CSB",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Griffin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.