Active NPI
Douglasville Healthcare Services, LLC
- Community/Behavioral Health Agency
- Evans, GA
National Provider Identifier
1619511334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- DOUGLASVILLE HEALTHCARE SERVICES, LLC
- Doing business as
- Treatment Center of Augusta
- Practice address
- 4158 Washington Rd Ste 4
Evans, GA 30809-4720 - Phone
- (706) 854-9225
- Fax
- (706) 854-9226
- NPI assigned
- Nov 6, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Alan Cooper Folsom
- Title
- Member
- Phone
- (229) 242-0953
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary | ||
| Methadone Clinic | 261QM2800X |
Addresses
Primary practice location
4158 Washington Rd Ste 4
Evans, GA 30809-4720
Mailing address
2935 N Ashley St Ste 114
Valdosta, GA 31602-1788
Phone (229) 242-0953
Other names 1
- Treatment Center of Augusta
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Opioid treatment program
- Medicare-enrolled since May 1, 2025
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250801002286 | GA | Part B Supplier - Opioid Treatment Program (Otp) | 5395253355 | Practice locations: Evans, GA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 11D2024811 | Treatment Center of Augusta | Certificate of waiver | May 23, 2027 |
National Provider Directory
National Provider DirectoryLocations
4158 Washington Rd
Ste 4
Evans, GA 30809
Phone (706) 854-9225
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Medicine Physician
- Augusta, GA
- NPI 1033113360
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1762214400000",
"number": "1619511334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2935 N ASHLEY ST STE 114",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316021788",
"telephone_number": "229-242-0953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4158 WASHINGTON RD STE 4",
"city": "EVANS",
"state": "GA",
"postal_code": "308094720",
"telephone_number": "706-854-9225",
"fax_number": "706-854-9226"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DOUGLASVILLE HEALTHCARE SERVICES, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-11-06",
"last_updated": "2025-11-04",
"certification_date": "2025-11-04",
"status": "A",
"authorized_official_last_name": "FOLSOM",
"authorized_official_first_name": "ALAN",
"authorized_official_middle_name": "COOPER",
"authorized_official_title_or_position": "MEMBER",
"authorized_official_telephone_number": "229-242-0953"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM2800X",
"taxonomy_group": "",
"desc": "Clinic/Center, Methadone",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Treatment Center of Augusta",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Evans, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.