NPIMap

Organization Active NPI

Community Service Board of Middle Georgia

Doing business as Soperton C&A Day Services

  • Community/Behavioral Health Agency
  • Soperton, GA
National Provider Identifier
1689707150
Registry record updated Jul 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA
Doing business as
Soperton C&A Day Services
Practice address
417 Louisiana Ave E
Soperton, GA 30457-1126
Phone
(478) 272-1190
Fax
(478) 274-7628
NPI assigned
Mar 14, 2007
Last updated
Jul 9, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2015

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

Authorized official

Name
Cynthia Reid
Title
Cfo
Phone
(478) 272-1190

Specialties & licenses 1

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

Addresses

Primary practice location

417 Louisiana Ave E
Soperton, GA 30457-1126

Mailing address

2121A Bellevue Rd
Dublin, GA 31021-2998
Phone (478) 272-1190

Other identifiers 1

IdentifierTypeStateIssuer
000606284MMedicaidGA

Other names 1

  • Soperton C&A Day Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Community Service Board of Middle Georgia30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

Locations

4129 E Louisiana Ave
Soperton, GA 30457
Phone (478) 272-1190

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436400000000",
    "number": "1689707150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121A BELLEVUE RD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310212998",
            "telephone_number": "478-272-1190",
            "fax_number": "478-274-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 LOUISIANA AVE E",
            "city": "SOPERTON",
            "state": "GA",
            "postal_code": "304571126",
            "telephone_number": "478-272-1190",
            "fax_number": "478-274-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2015-07-09",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "478-272-1190"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000606284M",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Soperton C&A Day Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Soperton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2015; 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.