MCINTOSH TRAIL COMMUNITY SERVICE BOARD (NPI# 1386708212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386708212 |
| Entity Type | Organization |
| Organization Name | MCINTOSH TRAIL COMMUNITY SERVICE BOARD |
| Practice Address |
1435 N Expressway Suite 301 Griffin GA 30223-9014 |
| Practice Telephone | 7703588250 |
| Practice Fax Number | 7702293223 |
| Mailing Telephone | 7703588250 |
| Mailing Fax Number | 7702293223 |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2017-02-10 |
| Authorized Official Name | MR. WESLEY M HUBBARD (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 7703588250 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | GA | Agencies |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871762252 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 1112 Broad Sreet, Griffin, GA 30223-2604 | 2008-02-29 |
| 1780853168 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 180 Watson Street, Jackson, GA 30233-1536 | 2008-02-29 |
| 1003085473 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 221 Laurel Street, Griffin, GA 30224-4731 | 2008-02-29 |
| 1699944074 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 13 Birnam Woods Road, Griffin, GA 30223-6684 | 2008-02-29 |
| 1952570335 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 318 North 3rd Street, Griffin, GA 30223-3354 | 2008-02-29 |
| 1073782447 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 403 Saddlecreek Drive, Mcdonough, GA 30253-8916 | 2008-02-29 |
| 1184893547 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 418 Meriwether Street, Griffin, GA 30224-4135 | 2008-02-29 |
| 1740459114 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 430 West Broad Street, Griffin, GA 30223-2826 | 2008-02-29 |
| 1336317270 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 1459 Williamson Rd, Griffin, GA 30224-8428 | 2008-02-13 |
| 1265610406 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 463 Ernest Biles Dr, Suite B, Jackson, GA 30233-2229 | 2008-02-08 |
| Street Address |
1435 N EXPRESSWAY SUITE 301 |
| City | GRIFFIN |
| State | GA |
| Zip Code | 30223-9014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801855051 | Select Physical Therapy Holdings Inc | Clinic/Center | 1435 N Expressway, Ste 201, Griffin, GA 30223-9016 | 2006-03-17 |
| 1629616073 | Michael Todd Stuart | Counselor | 1435 N Expressway, Griffin, GA 30223-9016 | 2019-12-17 |
| 1770907727 | Kenyatta Denise Walker | Social Worker | 1435 N Expressway, Suite 301, Griffin, GA 30223-9016 | 2014-02-11 |
| 1194147215 | Esop Rehabilitation, LLC | Clinic/Center | 1435 N Expressway, Suite 201, Griffin, GA 30223-1700 | 2014-01-08 |
| 1699018366 | John M Ellerbee | Physical Therapist | 1435 N Expressway, Suite 201, Griffin, GA 30223-9016 | 2013-04-01 |
| 1528199163 | Lenora Allen | Psychiatry & Neurology | 1435 N Expressway, Mcintosh Trail Csb, Griffin, GA 30223-9016 | 2007-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235783036 | Jennifer Lashawn Stevenson | Registered Nurse | 1071 Highway 16 West, Griffin, GA 30223 | 2019-07-30 |
| 1992357644 | Nikki Petty | Behavior Technician | 185 Grady Street, Griffin, GA 30223 | 2019-07-12 |
| 1568940146 | Brenda Pope | Counselor | 1710 Highway 16 West, Griffin, GA 30223 | 2018-08-05 |
| 1073025151 | Vonita Clowers | Specialist | 1424 N. Expy, Suite 115, Griffin, GA 30223 | 2017-10-30 |
| 1912427592 | Sheena Murphy | Registered Nurse | 109 N. 10th Street, Griffin, GA 30223 | 2017-06-23 |
| 1033639612 | Taralyn Rae Sams | Registered Nurse | 109 North 10th Street, Griffin, GA 30223 | 2017-06-23 |
| 1326594656 | Wendell Robinson | Registered Nurse | 109 N.10th Street, Griffin, GA 30223 | 2016-08-28 |
| 1508235466 | Trenisha Jones Mccall | Counselor | 1815 North Expressway, Griffin, GA 30223 | 2015-09-22 |
| 1104224948 | Dawn Tyus | Counselor | 424 W. Taylor Street, Griffin, GA 30223 | 2014-12-10 |
| 1003173030 | Ingles Markets Inc | Pharmacy | 1735 Zebulon Rd, Griffin, GA 30223 | 2012-04-16 |
| Find all providers in zip 30223 | ||||
| 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 |
|---|---|---|---|---|
| 1487171351 | Remember Me Community Outreach, Inc. | Community/Behavioral Health | 1444 Meriwether St, Griffin, GA 30224-3989 | 2017-08-23 |
| 1093262503 | Renewing Hope LLC | Community/Behavioral Health | 2896 N Expressway Ste A, Griffin, GA 30223-7254 | 2016-09-01 |
| 1760801179 | Perfect Choice Private Home Care | Community/Behavioral Health | 1704 W Poplar St, Griffin, GA 30224-7102 | 2014-04-14 |
| 1942557491 | Choice Lab, Inc | Community/Behavioral Health | 221b W Poplar St, Griffin, GA 30224-3032 | 2012-08-14 |
| 1497070007 | Safer Ground Community Services, Inc. | Community/Behavioral Health | 315 W Solomon St, Suite 210, Griffin, GA 30223-3038 | 2010-04-07 |
| 1427225655 | Pathways Center for Behavioral and Developmental Growth | Community/Behavioral Health | 1710 Highway 16 W, Griffin, GA 30223-7107 | 2008-05-16 |
| 1871762252 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 1112 Broad Sreet, Griffin, GA 30223-2604 | 2008-02-29 |
| 1003085473 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 221 Laurel Street, Griffin, GA 30224-4731 | 2008-02-29 |
| 1699944074 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 13 Birnam Woods Road, Griffin, GA 30223-6684 | 2008-02-29 |
| 1952570335 | Mcintosh Trail Community Service Board | Community/Behavioral Health | 318 North 3rd Street, Griffin, GA 30223-3354 | 2008-02-29 |
| Find all providers in GRIFFIN | ||||
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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.