11D2083753 CLIA NUMBER - COMMUNITY INTEGRATION HOME/AUGUSTA

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Laboratory Demographics

CLIA Number: 11D2083753

Facility Name: COMMUNITY INTEGRATION HOME/AUGUSTA

Facility Address:
2720 MIKE PADGETT HIGHWAY
AUGUSTA, GA
ZIP 30906
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Facility Phone Number: 706 193-0807

Facility Type: Other - COMMUNITY LIVING ARRANGEM

Certificate Type: Waiver

NPI Number: 1649718057

Taxonomy: 251S00000X - Community/Behavioral Health
A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment.

CLIA Record

Field Name	Field Value
CLIA Number	11D2083753
LAB Type	Other - COMMUNITY LIVING ARRANGEM
Facility Name	COMMUNITY INTEGRATION HOME/AUGUSTA
Street	2720 MIKE PADGETT HIGHWAY
City	AUGUSTA
State	GA
ZIP	30906
Phone	706 193-0807
CertificateType	4
CertificateEffectiveDate	9/11/2022
CertificateExpirationDate	9/10/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024