MCINTOSH TRAIL CSB (NPI# 1194993030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194993030 |
| Entity Type | Organization |
| Organization Name | MCINTOSH TRAIL CSB |
| Other Organization Name | BUTTS CO DD CENTER |
| Practice Address |
415 Ernest Biles Dr Jackson GA 30233-2282 |
| Mailing Address |
1501a Kalamazoo Dr Po Box 1320 Griffin GA 30224-3919 |
| Practice Telephone | 7707755129 |
| Mailing Telephone | 7703588250 |
| Mailing Fax Number | 7702293223 |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2008-02-13 |
| Authorized Official Name | PAMELA MCCOLLUM (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7703588251 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Butts Co DD Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811165483 | Mcintosh Trail Csb | Community/Behavioral Health | 1209 Greenbelt Dr, Griffin, GA 30224-4507 | 2008-02-15 |
| 1265600100 | Mcintosh Trail Csb | Community/Behavioral Health | 713 Andrews Dr, Thomaston, GA 30286-4524 | 2008-02-13 |
| 1174791016 | Mcintosh Trail Csb | Community/Behavioral Health | 514 W Poplar St, Griffin, GA 30224-2816 | 2008-02-13 |
| 1205004140 | Mcintosh Trail Csb | Community/Behavioral Health | 1343 W Poplar St, Griffin, GA 30224-2130 | 2008-02-13 |
| 1801064746 | Mcintosh Trail Csb | Community/Behavioral Health | 672 Industrial Blvd, Mcdonough, GA 30253-6611 | 2008-02-13 |
| 1477721397 | Mcintosh Trail Csb | Community/Behavioral Health | 1459 Williamson Road, Griffin, GA 30224-8428 | 2008-02-13 |
| 1841478013 | Mcintosh Trail Csb | Community/Behavioral Health | 101 Owens Ln, Po Box E, Barnesville, GA 30204-1438 | 2008-02-09 |
| 1023296282 | Mcintosh Trail Csb | Community/Behavioral Health | 318 Burg Rd, Jenkinsburg, GA 30234-2001 | 2008-02-08 |
| 1689852840 | Mcintosh Trail Csb | Community/Behavioral Health | 715 Bradley Dr, Fayetteville, GA 30214-2030 | 2008-02-08 |
| 1750569919 | Mcintosh Trail Csb | Community/Behavioral Health | 160 Carnegie Pl, Fayetteville, GA 30214-3905 | 2008-02-08 |
| Street Address |
415 ERNEST BILES DR |
| City | JACKSON |
| State | GA |
| Zip Code | 30233-2282 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366800914 | Georgia Ophthalmologists LLC | Durable Medical Equipment & Medical Supplies | 860 W 3rd St, Jackson, GA 30233 | 2016-02-10 |
| 1306225057 | Young Dreaden | Nurse Practitioner | 2978 Hwy 36w, Jackson, GA 30233 | 2015-05-28 |
| 1609255520 | Neta J Roby | Nurse Practitioner | Hwy 36, Georgia Diagnostic Classification Prison, Jackson, GA 30233 | 2015-05-26 |
| 1033546098 | Henrietta Lindsay | Social Worker | 463-b Ernest Biles Dr, Jackson, GA 30233 | 2013-10-04 |
| 1255776993 | Gareth Gene Walker | Technician | 514 Covinton Street, Jackson, GA 30233 | 2013-05-08 |
| 1730489592 | Mary L. Melton | Licensed Practical Nurse | 463 Ernest Biles Dr., Jackson, GA 30233 | 2010-10-27 |
| 1083864250 | Chastity Moore Brown | Dentist | 1520 Lucky Street, Griffin, GA 30233 | 2008-09-24 |
| 1568661320 | Joseph Fowlkes | Internal Medicine | 2978 Highway 36 W, Jackson, GA 30233 | 2007-07-12 |
| 1942386289 | Butts County Board of Commissioners | Ambulance | 154 Sylvan Drive, Jackson, GA 30233 | 2006-10-30 |
| 1841238300 | Jackson Pharmacy Services | Pharmacy | 22 Mulberry St., Jackson, GA 30233 | 2006-06-04 |
| Find all providers in zip 30233 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, 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. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437768801 | Abc Center for Learning Inc | Community/Behavioral Health | 4939 Ledgerock St, Jackson, MI 49201-8128 | 2020-07-30 |
| 1538703053 | Quest Fitness | Community/Behavioral Health | 1693 Lakeover Rd, Jackson, MS 39213-8015 | 2019-10-29 |
| 1326502535 | V.k. Johnson, Lcsw & Consultants, LLC | Community/Behavioral Health | 2637 Ridgewood Rd Ste De, Jackson, MS 39216-4922 | 2019-01-22 |
| 1215410816 | Feed Your Soul LLC | Community/Behavioral Health | 180 W University Pkwy Ste D, Jackson, TN 38305-1612 | 2018-09-10 |
| 1184103061 | Ymca of Greater Monmouth County | Community/Behavioral Health | 1025 Larsen Rd, Jackson, NJ 08527-1315 | 2018-08-10 |
| 1649759523 | Ymca of Greater Monmouth County | Community/Behavioral Health | 75 W Veterans Hwy, Jackson, NJ 08527-3403 | 2018-08-10 |
| 1558840439 | Ymca of Greater Monmouth County | Community/Behavioral Health | 125 N Hope Chapel Rd, Jackson, NJ 08527-2962 | 2018-08-10 |
| 1417436544 | Ymca of Greater Monmouth County | Community/Behavioral Health | 35 S Hope Chapel Rd, Jackson, NJ 08527-5019 | 2018-08-09 |
| 1568964112 | Apluscare, LLC | Community/Behavioral Health | 613 Atterbury Ct E, Jackson, NJ 08527-3182 | 2018-02-28 |
| 1043722465 | Apluscare, LLC | Community/Behavioral Health | 1012 Atterbury Ct E, Jackson, NJ 08527-3186 | 2017-10-25 |
| Find all providers in JACKSON | ||||
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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.