NPIMap

Organization Active NPI

Mental Retardation Waiver Program

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Cuthbert, GA
National Provider Identifier
1467647875
Registry record updated Sep 13, 2007
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
MENTAL RETARDATION WAIVER PROGRAM
Practice address
119 Claborn St.
Cuthbert, GA 39840
Phone
(706) 596-5583
NPI assigned
Sep 10, 2007
Last updated
Sep 13, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2007

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

Authorized official

Name
Perry Alexander
Title
Ceo
Phone
(706) 596-5582

Specialties & licenses 1

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

Addresses

Primary practice location

119 Claborn St.
Cuthbert, GA 39840

Mailing address

2100 Comer Ave
Columbus, GA 31904-8725
Phone (706) 321-9606

National Provider Directory

National Provider Directory
Tax ID family
New Horizons Comm SVC B46 organizations share this tax ID, including this one

Other organizations with this tax ID 45

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

View all 45

NPI Registry JSON

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

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189641600000",
    "number": "1467647875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 COMER AVE",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319048725",
            "telephone_number": "706-321-9606",
            "fax_number": "706-322-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CLABORN ST.",
            "city": "CUTHBERT",
            "state": "GA",
            "postal_code": "39840",
            "telephone_number": "706-596-5583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL RETARDATION WAIVER PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-13",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "PERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-596-5582"
    },
    "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": []
}

Other providers in Cuthbert, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; 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.