SOUTH GEORGIA CSB (NPI# 1053624585) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053624585 |
| Entity Type | Organization |
| Organization Name | SOUTH GEORGIA CSB |
| Other Organization Name | MIDTOWN MH-RESIDENTIAL |
| Practice Address |
1209 N Toombs St Valdosta GA 31601-3931 |
| Practice Telephone | 2296714255 |
| Mailing Telephone | 2296714255 |
| Enumeration Date | 2010-07-26 |
| Last Update Date | 2010-07-26 |
| Authorized Official Name | MRS. BRENDA HARRELL (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2296716100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GRP2255 | 05 |
| Other Name | Type Code |
|---|---|
| MIDTOWN MH-RESIDENTIAL | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386718187 | South Georgia Csb | Clinic/Center | 1644 E Park Ave, Valdosta, GA 31602-3413 | 2006-11-20 |
| 1871667675 | South Georgia Csb | Clinic/Center | 1108 S Patterson St, Valdosta, GA 31601-6348 | 2006-11-20 |
| 1730252479 | South Georgia Csb | Clinic/Center | 321 W Brantley, Lakeland, GA 31635 | 2006-11-17 |
| 1942374343 | South Georgia Csb | Clinic/Center | 340 Tifton Eldorado Road, Tifton, GA 31794 | 2006-11-17 |
| 1942374350 | South Georgia Csb | Clinic/Center | 203 Industrial Park Drive, Adel, GA 31620 | 2006-11-17 |
| 1154494359 | South Georgia Csb | Clinic/Center | 1200 Roundtree St, Quitman, GA 31643-3712 | 2006-11-16 |
| 1356414569 | South Georgia Csb | Clinic/Center | 391 County Farm Rd, Ashburn, GA 31714-3413 | 2006-11-16 |
| 1578636817 | South Georgia Csb | Residential Treatment Facility, Emotionally Disturbed Children | 4401 Willow Wood Gate, Valdosta, GA 31602-6709 | 2006-11-16 |
| 1407929730 | South Georgia Csb | Clinic/Center | 252 N Saint Augustine Rd, Valdosta, GA 31601-5274 | 2006-11-16 |
| 1558457655 | South Georgia Csb | Community/Behavioral Health | 334 Tifton Eldorado Rd, Tifton, GA 31794-9497 | 2006-10-05 |
| Street Address |
1209 N TOOMBS ST |
| City | VALDOSTA |
| State | GA |
| Zip Code | 31601-3931 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437700838 | Tristan Carlos Garcia | Specialist/Technologist | 605 West Mary Street, Valdosta, GA 31601 | 2019-09-26 |
| 1508332438 | Euniqua Lashay Williams | Contractor | 812 Lausanne Drive, Valdosta, GA 31601 | 2018-10-18 |
| 1457847634 | Valencia Meshay Johnson | Contractor | 1211 North Oak Street, Valdosta, GA 31601 | 2018-07-10 |
| 1376038042 | Restoration Care Services, LLC | Home Health | 704 Lake Park Road, Valdosta, GA 31601 | 2018-06-26 |
| 1609373133 | Ikea Sharnay Calhoun | Contractor | 1710 Dedo Drive, Valdosta, GA 31601 | 2018-04-11 |
| 1174049431 | Alexious Denson | Contractor | 900 Blanton St., Apt A16, Valdosta, GA 31601 | 2017-08-18 |
| 1578012258 | Clarissa Yolanda Alderman | Counselor | 4107 N Forrest Run Circle, Valdosta, GA 31601 | 2016-09-23 |
| 1225322613 | Andrea J. Ramirez | Counselor | 1301 Melody Ln Ste B, Valdosta, GA 31601 | 2011-06-03 |
| 1316248560 | L&r Personal Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14 Sharper Circle, Valdosta, GU 31601 | 2010-11-04 |
| 1902121809 | Grace Healthcare Services Inc | Respite Care | 1010 Slater Street, Valdosta, GA 31601 | 2010-04-02 |
| Find all providers in zip 31601 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528132321 | Behavioral Health Services of South Georgia | Community Based Residential Treatment Facility, Mental Illness | 1 Dellwood Cir, Valdosta, GA 31602-2335 | 2006-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417561747 | Georgia Regional Health LLC | Community Based Residential Treatment Facility, Mental Illness | 1211 Waterville Ct, Alpharetta, GA 30022-5381 | 2020-09-03 |
| 1275161192 | Monte Nido Georgia LLC | Community Based Residential Treatment Facility, Mental Illness | 124 Johnson Ferry Rd Ne, Sandy Springs, GA 30328-3004 | 2020-03-27 |
| 1811464035 | Hope Homes Recovery, LLC | Community Based Residential Treatment Facility, Mental Illness | 432 Virginia Rd, Atlanta, GA 30338-4793 | 2018-10-25 |
| 1770066029 | New Beginnings PCh of Columbus, LLC | Community Based Residential Treatment Facility, Mental Illness | 639 Lawyers Ln, Columbus, GA 31906-3812 | 2018-09-12 |
| 1588140859 | Butterfly Development, LLC | Community Based Residential Treatment Facility, Mental Illness | 1911 Grayson Highway, Suite 8-242, Grayson, GA 30017 | 2018-07-19 |
| 1326555210 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 101, Riverdale, GA 30274-1502 | 2018-01-02 |
| 1245747138 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 104, Riverdale, GA 30274-1502 | 2018-01-02 |
| 1235646217 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 401, Riverdale, GA 30274-1502 | 2017-12-29 |
| 1528574431 | House of Concrete Roses, LLC | Community Based Residential Treatment Facility, Mental Illness | 1133 Huff Rd Nw Apt 766, Atlanta, GA 30318-4327 | 2017-12-15 |
| 1508391756 | Mister Life Coach | Community Based Residential Treatment Facility, Mental Illness | 3681 N Decatur Rd Apt R11, Decatur, GA 30032-1062 | 2017-04-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.