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Highland Rivers Community Service Board

Organization Active NPI Community/Behavioral Health Agency · Cartersville, GA

NPI 1376896282 · NPPES record last updated Oct 17, 2012

Key facts

NPI
1376896282
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
HIGHLAND RIVERS COMMUNITY SERVICE BOARD
Practice address
12 Brookwood Dr
Cartersville, GA 30120-2106
Phone
(706) 270-5033
Fax
(706) 370-7749
NPI assigned
Oct 17, 2012
Organization subpart
No

Authorized official

Name
Robin Whitlow
Title
Billing Manager
Phone
(706) 270-5033

Corporate family (same tax ID) 24

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

National Provider Directory

Tax ID family
Highland Rivers Center CSB (123 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

12 Brookwood Dr
Cartersville, GA 30120-2106

Mailing address

1401 Applewood Dr Ste 1
Dalton, GA 30720-2699
Phone (706) 270-5033

Other identifiers

IdentifierTypeStateIssuer
000936559CUMedicaidGA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 17, 2012.

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1376896282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 APPLEWOOD DR STE 1",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202699",
            "telephone_number": "706-270-5033",
            "fax_number": "706-370-7749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 BROOKWOOD DR",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202106",
            "telephone_number": "706-270-5033",
            "fax_number": "706-370-7749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHLAND RIVERS COMMUNITY SERVICE BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "WHITLOW",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "706-270-5033"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000936559CU",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cartersville, GA

All providers in Cartersville, GA · Community/Behavioral Health Agency in Georgia

Sources for this page

Verify at the official NPI Registry.