NPIMap

Organization Active NPI

Georgia Dept of Human Resources

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Milledgeville, GA
National Provider Identifier
1912910936
Registry record updated Apr 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
005-01-026-9 Issued in GA
Legal business name
GEORGIA DEPT OF HUMAN RESOURCES
Practice address
170 Woodland Cir
Various Other Group Home Addresses
Milledgeville, GA 31061-2463
Phone
(478) 445-8182
NPI assigned
Aug 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2009

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

Authorized official

Name
Mr. George Harris
Title
Director
Phone
(478) 445-8182

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 005-01-026-9 GA Primary

Addresses

Primary practice location

170 Woodland Cir
Various Other Group Home Addresses
Milledgeville, GA 31061-2463

Mailing address

647 Swint Ave
Milledgeville, GA 31062-7525
Phone (478) 445-8182

Other identifiers 1

IdentifierTypeStateIssuer
000955578HMedicaidGA

Other names 1

  • Central Care Community SVS SME Other name

National Provider Directory

National Provider Directory
Tax ID family
Roosevelt Warm SGP Inst74 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239235200000",
    "number": "1912910936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "647 SWINT AVE",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310627525",
            "telephone_number": "478-445-8182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 WOODLAND CIR",
            "address_2": "VARIOUS OTHER GROUP HOME ADDRESSES",
            "city": "MILLEDGEVILLE",
            "state": "GA",
            "postal_code": "310612463",
            "telephone_number": "478-445-8182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA DEPT OF HUMAN RESOURCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-14",
        "last_updated": "2009-04-09",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "478-445-8182",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "005-01-026-9",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000955578H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Central Care Community SVS SME",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Milledgeville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; 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.