NPIMap

Mental Retardation Waiver Program

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Columbus, GA

NPI 1740475805 · NPPES record last updated Sep 12, 2007

Key facts

NPI
1740475805
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
MENTAL RETARDATION WAIVER PROGRAM
Practice address
2100 Comer Ave
Columbus, GA 31904-8725
Phone
(706) 596-5583
Fax
(706) 596-5589
NPI assigned
Sep 12, 2007
Organization subpart
Yes
Parent organization (as reported)
NEW HORIZONS COMMUNITY SERVICE BOARD

Authorized official

Name
Perry Alexander
Title
Ceo
Phone
(706) 596-5582

Corporate family (same tax ID) 45

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

View all 45

National Provider Directory

Tax ID family
New Horizons Comm SVC B (46 organizations share this tax ID)
Part of
New Horizons Comm SVC B

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

2100 Comer Ave
Columbus, GA 31904-8725

Mailing address

2100 Comer Ave
Columbus, GA 31904-8725
Phone (706) 596-5583

Other providers in Columbus, GA

All providers in Columbus, GA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia

Sources for this page

Verify at the official NPI Registry.