NPIMap

Organization Active NPI

Dekalb Community Service Board

  • Community/Behavioral Health Agency
  • Decatur, GA
National Provider Identifier
1922142108
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
DEKALB COMMUNITY SERVICE BOARD
Practice address
450 Winn Way
Decatur, GA 30030-1715
Phone
(404) 294-0499
Fax
(404) 294-0793
NPI assigned
Feb 19, 2007
Last updated
Apr 21, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
DEKALB COMMUNITY SERVICE BOARDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Authorized official

Name
Fabio Bruno Van Der Merwe
Title
Coo
Phone
(404) 294-3836

Specialties & licenses 1

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

Addresses

Primary practice location

450 Winn Way
Decatur, GA 30030-1715

Mailing address

450 Winn Way
Decatur, GA 30030-1715
Phone (404) 294-0499

Other names 1

  • DeKalb Regional Crisis Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Dekalb Community Serv24 organizations share this tax ID, including this one
Part of
Dekalb Community Serv

Other organizations with this tax ID 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587427200000",
    "number": "1922142108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301715",
            "telephone_number": "404-294-0499",
            "fax_number": "404-294-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301715",
            "telephone_number": "404-294-0499",
            "fax_number": "404-294-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB COMMUNITY SERVICE BOARD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DEKALB COMMUNITY SERVICE BOARD",
        "enumeration_date": "2007-02-19",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A",
        "authorized_official_last_name": "VAN DER MERWE",
        "authorized_official_first_name": "FABIO",
        "authorized_official_middle_name": "BRUNO",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "404-294-3836"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeKalb Regional Crisis Center",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "DeKalb Regional Crisis Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2020; 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.