NPIMap

Organization Active NPI

Middle Flint Community Service Board

  • Community/Behavioral Health Agency
  • Cordele, GA
National Provider Identifier
1982872172
Registry record updated Jan 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MIDDLE FLINT COMMUNITY SERVICE BOARD
Practice address
1335 N 5TH Street Ext Ste B
Cordele, GA 31015-3753
Phone
(229) 273-2091
Fax
(229) 931-2474
NPI assigned
Feb 11, 2008
Last updated
Jan 29, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MIDDLE FLINT AREA COMMUNITY SERVICE BOARDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 29, 2024

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

Authorized official

Name
Angela Holt
Title
Executive Director
Phone
(229) 815-5454

Specialties & licenses 1

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

Addresses

Primary practice location

1335 N 5TH Street Ext Ste B
Cordele, GA 31015-3753

Mailing address

415 N Jackson St
P.O. Drawer 1348
Americus, GA 31709-3015
Phone (229) 931-2470

Other identifiers 1

IdentifierTypeStateIssuer
000603237DMedicaidGA

Other names 2

  • Middle Flint Behavioral HealthCare AMHDT Other name
  • Phoenix House Other name

National Provider Directory

National Provider Directory
Tax ID family
Middle Flint Behavior H24 organizations share this tax ID, including this one
Part of
Middle Flint Behavior H

Other organizations with this tax ID 23

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

View all 23

Locations

1335 N 5th Street Ext
#B
Cordele, GA 31015
Phone (229) 273-2091

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1982872172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N JACKSON ST",
            "address_2": "P.O. DRAWER 1348",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093015",
            "telephone_number": "229-931-2470",
            "fax_number": "229-931-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1335 N 5TH STREET EXT STE B",
            "city": "CORDELE",
            "state": "GA",
            "postal_code": "310153753",
            "telephone_number": "229-273-2091",
            "fax_number": "229-931-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE FLINT COMMUNITY SERVICE BOARD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDDLE FLINT AREA COMMUNITY SERVICE BOARD",
        "enumeration_date": "2008-02-11",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "HOLT",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "229-815-5454"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000603237D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middle Flint Behavioral HealthCare AMHDT",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Middle Flint Behavioral HealthCare AMHDT",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Phoenix House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cordele, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2024; 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.