SOUTH GEORGIA CSB (NPI# 1154494359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154494359 |
| Entity Type | Organization |
| Organization Name | SOUTH GEORGIA CSB |
| Other Organization Name | BROOKS DD SERVICES |
| Practice Address |
1200 Roundtree St Quitman GA 31643-3712 |
| Practice Telephone | 2292637510 |
| Practice Fax Number | 2292634925 |
| Mailing Telephone | 2292637510 |
| Mailing Fax Number | 2292634925 |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2008-12-15 |
| Authorized Official Name | MRS. SUE GUPTON (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2296716101 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Brooks DD Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053624585 | South Georgia Csb | Community Based Residential Treatment Facility, Mental Illness | 1209 N Toombs St, Valdosta, GA 31601-3931 | 2010-07-26 |
| 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 |
| 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 |
1200 ROUNDTREE ST |
| City | QUITMAN |
| State | GA |
| Zip Code | 31643-3712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386168938 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1103 W Screven St, Quitman, GA 31643 | 2017-07-26 |
| 1245774025 | Shacora Travis | Contractor | 1200 Carney Road, Quitman, GA 31643 | 2016-12-13 |
| 1528358306 | Thomas Jackson Barrs | Pharmacist | 1103 West Screven St, Quitman, GA 31643 | 2011-04-13 |
| 1326356767 | Robert Eugene Jennings Jr. | Pharmacist | 510 Old Madison Rd, Quitman, GA 31643 | 2010-09-20 |
| 1275854515 | Marable's Heart-to-heart PCh Inc | Home Health | 83 Church Lane, Marable's Heart-to-heart Personal Care Home Inc., Quitman, GA 31643 | 2010-06-22 |
| 1871718577 | Mcleod-gaston Inc | Community/Behavioral Health | 102 N. Madison St., Quitman, GA 31643 | 2007-04-16 |
| 1598804197 | Debra M Seleska | Nurse Practitioner | 907 North Court Street, Quitman, GA 31643 | 2007-02-06 |
| 1184078537 | Brooks County Hospital | Radiology | 903 N Court St, Quitman, GA 31643 | 2016-04-21 |
| 1639523087 | Brooks County Hospital | Radiology | 903 N Court St, Quitman, GA 31643 | 2016-04-21 |
| 1538513981 | Brooks County Hospital | Radiology | 903 N Court St, Quitman, GA 31643 | 2016-04-21 |
| Find all providers in zip 31643 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| 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.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922653534 | Five Star Education Advocacy Group Inc | Clinic/Center | 978 Fellowship Rd, Fairburn, GA 30213-1789 | 2019-08-09 |
| 1205329687 | Advantage Behavioral Health Systems | Clinic/Center | 638 Michael Cir., Monroe, GA 30655 | 2018-06-11 |
| 1215420690 | Advantage Behavioral Health Systems | Clinic/Center | 1801 Prospect Rd., Madison, GA 30650 | 2018-06-11 |
| 1285149955 | Alicia Gordon | Clinic/Center | 132 Carol Cir, Fitzgerald, GA 31750-8128 | 2017-12-04 |
| 1225567597 | Vincentia Paul-constantin | Clinic/Center | 2867 Country House Lane, Buford, GA 30519 | 2017-06-08 |
| 1598158909 | Musik To Grow | Clinic/Center | 1517 Johnson Ferry Rd, Marietta, GA 30062-6493 | 2015-03-09 |
| 1356692800 | Ridgewood Personal Care Home, Inc | Clinic/Center | 1065 Murray Cir Sw, Marietta, GA 30064-3927 | 2012-09-24 |
| 1790055432 | Trapeze Therapy, LLC | Clinic/Center | 160 Tracy St, Suite A, Athens, GA 30601-1979 | 2012-01-11 |
| 1326316274 | Early/miller Day (now) | Clinic/Center | 302 Damacus Street, Blakely, GA 39823-3346 | 2011-12-07 |
| 1710255773 | Early Miller Personal Support (now) | Clinic/Center | 302 Damascus Street, Blakely, GA 39823-3346 | 2011-12-06 |
| 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.