NPIMap

Organization Active NPI

Bulloch Recovery Resources

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Statesboro, GA
National Provider Identifier
1689993461
Registry record updated May 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
2010000179 Issued in GA
Legal business name
BULLOCH RECOVERY RESOURCES
Practice address
18 Simmons Center
Statesboro, GA 30458
Phone
(912) 489-8401
Fax
(912) 489-4316
NPI assigned
May 19, 2010
Organization subpart
Yes
Parent organization
BULLOCH DUI RISK REDUCTION, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 19, 2010

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

Authorized official

Name
Cindy Mitchell Howard
Title
Owner-Counselor
Phone
(912) 489-8401

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Family Planning Facility 261QA0005X 2010000179 GA
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 2010000179 GA
Adult Mental Health Clinic/Center 261QM0850X 2010000179 GA
Adolescent and Children Mental Health Clinic/Center 261QM0855X 2010000179 GA
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 2010000179 GA Primary

Addresses

Primary practice location

18 Simmons Center
Statesboro, GA 30458

Mailing address

18 Simmons Center
Statesboro, GA 30458
Phone (912) 489-8401

National Provider Directory

National Provider Directory
Part of
Bulloch Recovery Resources

NPI Registry JSON

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

{
    "created_epoch": "1274227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274227200000",
    "number": "1689993461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 SIMMONS CENTER",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-489-8401",
            "fax_number": "912-489-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 SIMMONS CENTER",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-489-8401",
            "fax_number": "912-489-4316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BULLOCH RECOVERY RESOURCES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BULLOCH DUI RISK REDUCTION, INC",
        "enumeration_date": "2010-05-19",
        "last_updated": "2010-05-19",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "OWNER-COUNSELOR",
        "authorized_official_telephone_number": "912-489-8401"
    },
    "taxonomies": [
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": "GA",
            "license": "2010000179",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "GA",
            "license": "2010000179",
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "GA",
            "license": "2010000179",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "GA",
            "license": "2010000179",
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "GA",
            "license": "2010000179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; 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.