Georgia Department of Human Resources
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Milledgeville, GA
NPI 1831334515 · NPPES record last updated Dec 9, 2008
Key facts
- NPI
- 1831334515
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Legal business name
- GEORGIA DEPARTMENT OF HUMAN RESOURCES
- Practice address
- 620 Broad St
Central Care-Yarbrough BLDG-3Rd Floor
Milledgeville, GA 31062-7525 - Phone
- (478) 445-8182
- NPI assigned
- Dec 9, 2008
- Organization subpart
- Yes
- Parent organization (as reported)
- GEORGIA DEPARTMENT OF HUMAN RESOURCES
Authorized official
- Name
- Mr. George Harris
- Title
- Director
- Phone
- (478) 445-8182
Corporate family (same tax ID) 22
National Provider Directory
- Tax ID family
- Roosevelt Warm SGP Inst
- Part of
- Roosevelt Warm SGP Inst
Locations
620 Broad St
Bldg 3RD
Milledgeville, GA 31062
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Yes |
Addresses
Primary practice location
620 Broad St
Central Care-Yarbrough BLDG-3Rd Floor
Milledgeville, GA 31062-7525
Mailing address
620 Broad St
Central Care-Yarbrough BLDG-3Rd Floor
Milledgeville, GA 31062-7525
Phone (478) 445-8182
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000355737AK | Medicaid | GA | |
| 000355737X | Medicaid | GA |
Other names
- Central Care (Day Habilitation)
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All providers in Milledgeville, GA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.