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Contact Information

COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA
410 LAKESIDE DRIVE
MCRAE, GA31055
 Phone: 478-272-1190
 Fax: 478-274-7628
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Behavioral Health

251S00000X
Indicates primary specialty

NPI Profile & details for COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA

NPI # 1912030008
LBN Legal business name COMMUNITY SERVICE BOARD OF MIDDLE GEORGIA
Authorized official ROBERT MORAN - (CFO)
Entity Organization
Organization subpart 1 No
Enumeration date 03/14/2007
Last updated 07/16/2015 - About 11 years ago
Identifiers
GA Medicaid 000606284L
GA Medicaid 300030912A
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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