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CSB OF EAST CENTRAL GEORGIA NPI 1659544369


NPI Information

NPI: 1659544369
Provider Name: CSB OF EAST CENTRAL GEORGIA
Classification: Clinic/Center - 261QD1600X
Entity Type: Organization

Specialization: Developmental Disabilities

Address:
3421 MIKE PADGETT HWY
AUGUSTA, GA
ZIP 30906
Phone: (706) 432-4858
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CSB OF EAST CENTRAL GEORGIA is a developmental disabilities clinic center in Augusta, GA. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). CSB OF EAST CENTRAL GEORGIA NPI is 1659544369. The provider is registered as an organization entity type.

The provider's business location address is:

3421 MIKE PADGETT HWY
AUGUSTA, GA
ZIP 30906-815
Phone: (706) 432-4858
Fax: (706) 432-3780

The provider's authorized official is Wanda Jessie .
The authorized official title is Billing Supervisor and has the following contact phone number (706) 432-4858.

The enumeration date for this NPI number is 4/3/2008 and was last updated on 6/19/2008.


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
1261QD1600XClinic/CenterDevelopmental DisabilitiesGEORGIAYes

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
100605833EMEDICAIDGEORGIA
2GRP2010MEDICARE PINGEORGIA

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

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