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METHODIST HOME OF THE SOUTH GA CONFERENCE NPI 1568524882


NPI Information

NPI: 1568524882
Provider Name: METHODIST HOME OF THE SOUTH GA CONFERENCE

Other Name: METHODIST HOME FOR CHILDREN AND YOUTH

Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 11D2096605

Address:
304 PIERCE AVE
MACON, GA
ZIP 31204
Phone: (478) 751-2800
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METHODIST HOME OF THE SOUTH GA CONFERENCE is a community behavioral health in Macon, 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. METHODIST HOME OF THE SOUTH GA CONFERENCE NPI is 1568524882. The provider is registered as an organization entity type.
The provider Other Name Is Methodist Home For Children And Youth.

The provider's business location address is:

304 PIERCE AVE
MACON, GA
ZIP 31204-422
Phone: (478) 751-2800

The provider's authorized official is Steve L Rumford .
The authorized official title is President And Ceo and has the following contact phone number (478) 751-2800.

The CLIA number assigned to this NPI record is 11D2096605 - other - behavioral health ctr with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/14/2006 and was last updated on 8/22/2020.


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 HealthCPA001036GEORGIANo
2251S00000XCommunity/Behavioral HealthCI0000011053GEORGIANo
3251S00000XCommunity/Behavioral HealthCCI11006GEORGIANo
4251S00000XCommunity/Behavioral HealthCI0000012098GEORGIANo
5251S00000XCommunity/Behavioral HealthCI0000012147GEORGIAYes
6251S00000XCommunity/Behavioral HealthGEORGIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100271679CMEDICAIDGEORGIA
200927671BMEDICAIDGEORGIA

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.