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Community Service Board of Middle Georgia

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

NPI 1477074698 · NPPES record last updated Jun 28, 2017

Key facts

NPI
1477074698
Entity type
Organization (NPI type 2)
Primary specialty
Community/Behavioral Health Agency 251S00000X
Legal business name
COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA
Practice address
1114 Clarks Mill Rd
Louisville, GA 30434-5304
Phone
(478) 625-7214
Fax
(478) 625-7240
NPI assigned
Jun 28, 2017
Organization subpart
No

Authorized official

Name
Keith Moran
Title
Cfo
Phone
(478) 272-6811

Corporate family (same tax ID) 29

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

View all 29

National Provider Directory

Tax ID family
Community Service Board of Middle Georgia (30 organizations share this tax ID)

Specialties & licenses

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

Addresses

Primary practice location

1114 Clarks Mill Rd
Louisville, GA 30434-5304

Mailing address

223 N Anderson Dr
Swainsboro, GA 30401-4440
Phone (478) 289-2683

Other identifiers

IdentifierTypeStateIssuer
000709288TMedicaidGA

Other providers in Louisville, GA

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

Sources for this page

Verify at the official NPI Registry.