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Community Service Board of Middle Georgia

Organization Active NPI Mental Health Clinic/Center (Including Community Mental Health Center) · Sylvania, GA

NPI 1881114239 · NPPES record last updated Jun 26, 2017

Key facts

NPI
1881114239
Entity type
Organization (NPI type 2)
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Legal business name
COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA
Practice address
302 E Ogeechee St
Sylvania, GA 30467-2403
Phone
(912) 564-7825
Fax
(912) 564-5778
NPI assigned
Jun 26, 2017
Organization subpart
No

Authorized official

Name
Keith Moran
Title
Cfo
Phone
(478) 275-6811

Corporate family (same tax ID) 29

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

View all 29

National Provider Directory

Tax ID family
Community Service Board of Middle Georgia (30 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Yes

Addresses

Primary practice location

302 E Ogeechee St
Sylvania, GA 30467-2403

Mailing address

223 N Anderson Dr
Swainsboro, GA 30401-4440
Phone (478) 289-2683

Other identifiers

IdentifierTypeStateIssuer
000606383EMedicaidGA

Other providers in Sylvania, GA

All providers in Sylvania, GA · Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

Sources for this page

Verify at the official NPI Registry.