NPIMap

Organization Active NPI

South Georgia CSB

Doing business as Cook DD Services

  • Developmental Disabilities Clinic/Center
  • Adel, GA
National Provider Identifier
1942374350
Registry record updated Dec 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
SOUTH GEORGIA CSB
Doing business as
Cook DD Services
Practice address
203 Industrial Park Drive
Adel, GA 31620
Phone
(229) 896-7994
Fax
(229) 896-3709
NPI assigned
Nov 17, 2006
Last updated
Dec 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2008

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

Authorized official

Name
Mrs. Sue Gupton
Title
Chief Executive Officer
Phone
(229) 671-6101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary

Addresses

Primary practice location

203 Industrial Park Drive
Adel, GA 31620

Mailing address

203 Industrial Park Drive
Adel, GA 31620
Phone (229) 896-7994

Other identifiers 2

IdentifierTypeStateIssuer
000607032AMedicaidGA
000607032WMedicaidGA

Other names 1

  • Cook DD Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Behavioral Health Crisis Center29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

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

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1942374350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 INDUSTRIAL PARK DRIVE",
            "city": "ADEL",
            "state": "GA",
            "postal_code": "31620",
            "telephone_number": "229-896-7994",
            "fax_number": "229-896-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 INDUSTRIAL PARK DRIVE",
            "city": "ADEL",
            "state": "GA",
            "postal_code": "31620",
            "telephone_number": "229-896-7994",
            "fax_number": "229-896-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH GEORGIA CSB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "GUPTON",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "229-671-6101",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000607032A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000607032W",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cook DD Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Adel, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; 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.