MCINTOSH TRAIL CSB NPI 1801064746

NPI Information

  • NPI: 1801064746
  • Provider Name: MCINTOSH TRAIL CSB
  • Classification: Community/Behavioral Health - 251S00000X
  • Entity Type: Organization
  • Doing Business As: HENRY DD SERVICE CENTER
  • Address: 672 INDUSTRIAL BLVD
    MCDONOUGH, GA
    ZIP 30253
  • Phone: (770) 358-8258

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NPI Details

MCINTOSH TRAIL CSB is a community behavioral health in Mcdonough, 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. MCINTOSH TRAIL CSB NPI is 1801064746. The provider is registered as an organization entity type.
The provider Is Doing Business As Henry Dd Service Center.

The provider's business location address is:

672 INDUSTRIAL BLVD
MCDONOUGH, GA
ZIP 30253-611
Phone: (770) 358-8258
Fax: (770) 229-3223

The provider's authorized official is Mike Hubbard .
The authorized official title is Ceo and has the following contact phone number (770) 358-8251.

The enumeration date for this NPI number is 2/13/2008 and was last updated on 12/17/2015.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1251S00000XCommunity/Behavioral HealthYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000603435NMEDICAIDGEORGIA
2000603435FMEDICAIDGEORGIA

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: 3/30/2025

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