CSB OF EAST CENTRAL GA


Address: 2208 Walden Dr, Augusta, GA 30904-6508
Phone: 7064324858

CSB OF EAST CENTRAL GA (NPI# 1679804215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679804215
Entity Type Organization
Organization Name CSB OF EAST CENTRAL GA
Other Organization Name WALTON MANOR PCH
Practice Address 2208 Walden Dr
Augusta
GA 30904-6508
Mailing Address 3421 Mike Padgett Hwy
Augusta
GA 30906-3815
Practice Telephone 7064324858
Practice Fax Number 7064323780
Mailing Telephone 7064324858
Mailing Fax Number 7064323780
Enumeration Date 2010-01-21
Last Update Date 2010-01-21
Authorized Official Name WANDA JESSIE (BILLING MANAGER)
Authorized Official Telephone 7064324858
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities Residential Treatment Facilities

Other Provider Identifier

State Issuer Identifier Type Code
GA 000605833K 05

Other Provider/Organization Names

Other Name Type Code
WALTON MANOR PCH Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1467013821 Csb of East Central Ga Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 5101 Parnell Way, Martinez, GA 30907-8896 2019-06-26
1811436512 Csb of East Central Ga Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 4008 Ramswood Dr, Hephzibah, GA 30815-5849 2017-02-15
1508305285 Csb of East Central Ga Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 3126 Richmond Hill Rd, Augusta, GA 30906-4754 2017-02-15
1447798707 Csb of East Central Ga Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 355 Bobwhite Trl, Grovetown, GA 30813-5886 2017-02-07
1346565926 Csb of East Central Ga Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 3015 Manchester Dr, Hephzibah, GA 30815-7166 2010-04-07
1700101391 Csb of East Central Ga Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2006 Country Place Dr, Augusta, GA 30906-8732 2010-04-07
1588995112 Csb of East Central Ga Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 386 Tower Rd, Augusta, GA 30907-8750 2010-01-21
1881925410 Csb of East Central Ga Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 3461 Camak Dr, Augusta, GA 30909-9433 2010-01-21
1053642686 Csb of East Central Ga Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2115 Ashley Dr, Augusta, GA 30906-5085 2010-01-21
1790016327 Csb of East Central Ga Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2110 Stevens Rd, Augusta, GA 30906-2058 2010-01-21

Office Location

Street Address 2208 WALDEN DR
City AUGUSTA
State GA
Zip Code 30904-6508

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518423706 Lawren Murray Tachias Registered Nurse 950 15th Street Downtown, Augusta, GA 30904 2019-02-13
1457851842 Heba Ahmed Pharmacist 912 15th Street, Augusta, GA 30904 2018-02-13
1124552690 Jenny Liles Student in an Organized Health Care Education/Training Program 1004 Chafee Ave, Augusta, GA 30904 2017-04-11
1932640836 Claudia Crawford Student in an Organized Health Care Education/Training Program 2624 Oakland Ave., Augusta, GA 30904 2017-03-13
1801240528 F. Marion Durst IIi Dmd PC Clinic/Center 2325 Washington Road, Augusta, GA 30904 2016-04-19
1689031296 Teresa Maria Martin Counselor 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 2016-01-27
1598122269 Jillian Wilkerson Counselor Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 2016-01-26
1760855241 Chase King Occupational Therapist 1735 Berkeley Rd, Augusta, GA 30904 2015-11-05
1962832246 April Underwood Fox Physician Assistant 1417 Pendleton Rd, Augusta, GA 30904 2013-11-22
1861734378 John Graham Theisen Obstetrics & Gynecology 810 Chafee Avenue, Augusta, GA 30904 2013-03-22
Find all providers in zip 30904

Taxonomy Information

Taxonomy Code 320600000X
Grouping Residential Treatment Facilities
Classification Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1942691431 Vincent Roselli Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2416 Eagle Dr, Augusta, GA 30906-3325 2015-02-05
1861735391 Beverly Briggs Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 3520 Primrose Ct, Augusta, GA 30906-9576 2013-04-03
1821392572 Renee's Personal Care Home, LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 1916 Ohio Ave, Augusta, GA 30904-5329 2011-01-10
1700101391 Csb of East Central Ga Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2006 Country Place Dr, Augusta, GA 30906-8732 2010-04-07
1588995112 Csb of East Central Ga Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 386 Tower Rd, Augusta, GA 30907-8750 2010-01-21
1881925410 Csb of East Central Ga Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 3461 Camak Dr, Augusta, GA 30909-9433 2010-01-21
1053642686 Csb of East Central Ga Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2115 Ashley Dr, Augusta, GA 30906-5085 2010-01-21
1790016327 Csb of East Central Ga Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 2110 Stevens Rd, Augusta, GA 30906-2058 2010-01-21
1437480035 Csb of East Central Ga Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 313 S Belair Rd, Augusta, GA 30907-8835 2010-01-21
1366773905 Csb of East Central Ga Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 4027 Wheeler Rd, Augusta, GA 30901 2010-01-21
Find all providers in AUGUSTA

Competitor

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City AUGUSTA
Zip Code 30904

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Dataset Information

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.

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