NPIMap

Organization Active NPI

Cobb County Community Services Board

  • Developmentally Disabled Services Day Training Agency
  • Smyrna, GA
National Provider Identifier
1720120033
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
COBB COUNTY COMMUNITY SERVICES BOARD
Practice address
2051 Greenridge Rd SE
Smyrna, GA 30080-1116
Phone
(770) 434-7911
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tod Citron
Title
Ceo
Phone
(770) 429-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

2051 Greenridge Rd SE
Smyrna, GA 30080-1116

Mailing address

3830 S Cobb Dr SE
Suite 300
Smyrna, GA 30080-5532
Phone (770) 429-5000

Other identifiers 4

IdentifierTypeStateIssuer
00599695AMedicaidGA
00603556AMedicaidGA
00961705BMedicaidGA
00603556BMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Cobb County Community Services Board13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

2051 Greenridge Rd SE
Smyrna, GA 30080
Phone (770) 434-7911

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720120033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 S COBB DR SE",
            "address_2": "SUITE 300",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300805532",
            "telephone_number": "770-429-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 GREENRIDGE RD SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300801116",
            "telephone_number": "770-434-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBB COUNTY COMMUNITY SERVICES BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CITRON",
        "authorized_official_first_name": "TOD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-429-5000"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00599695A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00603556A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00961705B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00603556B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.