NPIMap

Organization Active NPI

Cobb County Community Services Board

  • Community/Behavioral Health Agency
  • Smyrna, GA
National Provider Identifier
1750442331
Registry record updated Jan 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COBB COUNTY COMMUNITY SERVICES BOARD
Practice address
3830 S Cobb Dr SE
Suite 300
Smyrna, GA 30080-5532
Phone
(770) 429-5000
NPI assigned
Dec 13, 2006
Last updated
Jan 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2021

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

Authorized official

Name
Tod Citron
Title
Executive Director
Phone
(770) 429-5000

Specialties & licenses 1

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

Addresses

Primary practice location

3830 S Cobb Dr SE
Suite 300
Smyrna, GA 30080-5532

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1750442331. Details of each certification follow.

  • CCN 114621 Community mental health center · Active · Name & address match · Details

Community mental health center certification: CCN 114621

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COBB COUNTY COMMUNITY SERVICE BOARD
Certification status
Active
Provider type (POS)
Community mental health center
Participating since
Mar 22, 2005
Last certification
Mar 22, 2005
Ownership / control type
Non-profit – church related
Facility address
3830 South Cobb Drive, Suite 30
Smyrna, GA 30080

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1750442331",
    "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": "3830 S COBB DR SE",
            "address_2": "SUITE 300",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300805532",
            "telephone_number": "770-429-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBB COUNTY COMMUNITY SERVICES BOARD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "CITRON",
        "authorized_official_first_name": "TOD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "770-429-5000"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

Verify at the official NPI Registry.