NPIMap

Organization Active NPI

CSB of East Central Ga

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Grovetown, GA
National Provider Identifier
1447798707
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
CSB OF EAST CENTRAL GA
Practice address
355 Bobwhite TRL
Grovetown, GA 30813-5886
Phone
(706) 432-4928
Fax
(706) 432-3861
NPI assigned
Feb 7, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Authorized official

Name
Heather Dubose
Title
Residential Manager
Phone
(706) 432-4928

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

355 Bobwhite TRL
Grovetown, GA 30813-5886

Mailing address

3421 Mike Padgett Hwy
BLDG a
Augusta, GA 30906-3815
Phone (706) 432-4928

Other names 1

  • Jones HH Other name

National Provider Directory

National Provider Directory
Tax ID family
CSB of East Central Ga49 organizations share this tax ID, including this one

Other organizations with this tax ID 48

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

View all 48

NPI Registry JSON

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

{
    "created_epoch": "1486425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486425600000",
    "number": "1447798707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 MIKE PADGETT HWY",
            "address_2": "BLDG A",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309063815",
            "telephone_number": "706-432-4928",
            "fax_number": "706-432-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 BOBWHITE TRL",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308135886",
            "telephone_number": "706-432-4928",
            "fax_number": "706-432-3861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CSB OF EAST CENTRAL GA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-07",
        "last_updated": "2017-02-07",
        "status": "A",
        "authorized_official_last_name": "DUBOSE",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "RESIDENTIAL MANAGER",
        "authorized_official_telephone_number": "706-432-4928"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jones HH",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Grovetown, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; 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.