Provider Type Icon

DEKALB COMMUNITY SERVICE BOARD NPI 1134264179


NPI Information

NPI: 1134264179
Provider Name: DEKALB COMMUNITY SERVICE BOARD

Other Name: DEKALB ADDICTION CLINIC

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
455 WINN WAY
DECATUR, GA
ZIP 30030
Phone: (404) 508-6430
Get Directions

DEKALB COMMUNITY SERVICE BOARD is a community behavioral health in Decatur, GA. The provider is 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. DEKALB COMMUNITY SERVICE BOARD NPI is 1134264179. The provider is registered as an organization entity type.
The provider Other Name Is Dekalb Addiction Clinic.

The provider's business location address is:

455 WINN WAY
DECATUR, GA
ZIP 30030-707
Phone: (404) 508-6430
Fax: (404) 508-6434

The provider's authorized official is Fabio Bruno Van Der Merwe .
The authorized official title is Coo and has the following contact phone number (404) 294-3836.

The enumeration date for this NPI number is 2/20/2007 and was last updated on 4/21/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral HealthYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.