NPIMap

Organization Active NPI

Bertha Richardsaon

  • Community/Behavioral Health Agency
  • Waycross, GA
National Provider Identifier
1770855868
Registry record updated Feb 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
BERTHA RICHARDSAON
Practice address
1614 Carswell Ave
Waycross, GA 31503
Phone
(912) 285-5171
Fax
(912) 449-7111
NPI assigned
Feb 3, 2012
Last updated
Feb 3, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
SATILLA COMMUNITY SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 3, 2012

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

Authorized official

Name
Bobby Brown
Title
Ceo
Phone
(912) 449-7111

Specialties & licenses 1

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

Addresses

Primary practice location

1614 Carswell Ave
Waycross, GA 31503

Mailing address

1007 Mary St
Waycross, GA 31503-3823
Phone (912) 449-7111

National Provider Directory

National Provider Directory
Tax ID family
Satilla Community SRVC71 organizations share this tax ID, including this one
Part of
Satilla Community SRVC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1614 Carswell Ave
Waycross, GA 31503
Phone (912) 285-5171

NPI Registry JSON

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

{
    "created_epoch": "1328227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328227200000",
    "number": "1770855868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 MARY ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315033823",
            "telephone_number": "912-449-7111",
            "fax_number": "912-449-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1614 CARSWELL AVE",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "31503",
            "telephone_number": "912-285-5171",
            "fax_number": "912-449-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERTHA RICHARDSAON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SATILLA COMMUNITY SERVICES",
        "enumeration_date": "2012-02-03",
        "last_updated": "2012-02-03",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "BOBBY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-449-7111"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; 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.