NPIMap

Organization Active NPI

Laurens County Board of Health

Doing business as Early Intervention Case MGT

  • Early Intervention Provider Agency
  • Dublin, GA
National Provider Identifier
1770765828
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
LAURENS COUNTY BOARD OF HEALTH
Doing business as
Early Intervention Case MGT
Practice address
1623 Rice Ave
Dublin, GA 31021-3522
Phone
(478) 275-6841
Fax
(478) 274-7893
NPI assigned
Nov 30, 2007
Last updated
Nov 30, 2007By the provider in NPPES
Organization subpart
Yes
Parent organization
LAURENS COUNTY BOARD OF HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Authorized official

Name
Mr. Bruce Wilkes Evans
Title
Administrator
Phone
(478) 275-6545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

1623 Rice Ave
Dublin, GA 31021-3522

Mailing address

1623 Rice Ave
Dublin, GA 31021-3522
Phone (478) 275-6841

Other names 1

  • Early Intervention Case MGT Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Laurens County Health D5 organizations share this tax ID, including this one
Part of
Laurens County Health D

Other organizations with this tax ID 4

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

Locations

1623 Rice Ave
Dublin, GA 31021
Phone (478) 275-6842

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196380800000",
    "number": "1770765828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 RICE AVE",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213522",
            "telephone_number": "478-275-6841",
            "fax_number": "478-274-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 RICE AVE",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213522",
            "telephone_number": "478-275-6841",
            "fax_number": "478-274-7893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAURENS COUNTY BOARD OF HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LAURENS COUNTY BOARD OF HEALTH",
        "enumeration_date": "2007-11-30",
        "last_updated": "2007-11-30",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "WILKES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "478-275-6545",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Early Intervention Case MGT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; 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.