NPIMap

Organization Active NPI

GRN CSB

  • Community/Behavioral Health Agency
  • Lawrenceville, GA
National Provider Identifier
1497046882
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
APC002422 Issued in GA
Legal business name
GRN CSB
Practice address
490 S Perry St
Lawrenceville, GA 30046-4837
Phone
(770) 339-2321
NPI assigned
Apr 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Authorized official

Name
Mr. Jack E Underwood Jr., LAPC
Title
Clinician
Phone
(770) 339-2259

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X APC002422 GA Primary

Addresses

Primary practice location

490 S Perry St
Lawrenceville, GA 30046-4837

Mailing address

490 S Perry St
Lawrenceville, GA 30046-4837
Phone (770) 339-2321

National Provider Directory

National Provider Directory
Tax ID family
GRN Community Service Board21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

Locations

490 S Perry St
Lawrenceville, GA 30046
Phone (678) 278-9244

NPI Registry JSON

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

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1497046882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 S PERRY ST",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464837",
            "telephone_number": "770-339-2321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 S PERRY ST",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300464837",
            "telephone_number": "770-339-2321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRN CSB",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-20",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "770-339-2259",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LAPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "APC002422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.