GEORGIA DEPARTMENT OF HUMAN RESOURCES (NPI# 1912075904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912075904 |
| Entity Type | Organization |
| Organization Name | GEORGIA DEPARTMENT OF HUMAN RESOURCES |
| Other Organization Name | GRACEWOOD COMMUNITY SERVICES |
| Practice Address |
3004 Cromwell Ct Hephzibah GA 30815-6212 |
| Mailing Address |
100 Myrtle Blvd Gracewood GA 30812-1500 |
| Practice Telephone | 7067902034 |
| Mailing Telephone | 7067902030 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. GAIL C JACKSON (REGIONAL HOSPITAL ADMINISTRATOR) |
| Authorized Official Telephone | 7067902030 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | NA | GA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Gracewood Community Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356586259 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1631 Valley Cir, Milledgeville, GA 31062-0001 | 2008-12-05 |
| 1609029925 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 138 Swint Ave Se, Milledgeville, GA 31061-3928 | 2008-10-30 |
| 1154597672 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 120 Daphney St Se, Milledgeville, GA 31061-4342 | 2008-05-05 |
| 1184895823 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 419 Moye Dr, Sandersville, GA 31082-7624 | 2008-03-21 |
| 1841487667 | Georgia Department of Human Resources | General Acute Care Hospital | 2400 Vinson Hwy, Milledgeville, GA 31062-0001 | 2007-09-25 |
| 1679614515 | Georgia Department of Human Resources | Clinic/Center | 1309 Redmond Rd Nw, Rome, GA 30165-1307 | 2007-02-12 |
| 1164583274 | Georgia Department of Human Resources | Case Management | 2 Peachtree St., 9th Fl., Atlanta, GA 30303-3142 | 2006-12-12 |
| 1568530798 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3533 Stafford St, Hephzibah, GA 30815-6625 | 2006-12-04 |
| 1366510067 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2311 Mura Dr, Augusta, GA 30906-4819 | 2006-12-01 |
| 1629146311 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3518 Snowden Dr, Hephzibah, GA 30815-6631 | 2006-12-01 |
| Street Address |
3004 CROMWELL CT |
| City | HEPHZIBAH |
| State | GA |
| Zip Code | 30815-6212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881966406 | Americanwork, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3004 Cromwell Ct, Hephzibah, GA 30815-6212 | 2012-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679091458 | Specialized Healthcare Services Inc | In Home Supportive Care | 2920 Tobacco Road, Suit A, Hephzibah, GA 30815 | 2017-08-31 |
| 1144747437 | Willie Mae Berry Pugh | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2013 Teal Court, Hephzibah, GA 30815 | 2017-08-28 |
| 1811448319 | Butterfly Gardens Hospice & Palliative Care | Hospice, Inpatient | 3112 Blackmon Court, Hephzibah, GA 30815 | 2016-10-19 |
| 1841651098 | Michelle Sherrie Coleman | Home Health Aide | 2708 Bob White Court, Hephzibah, GA 30815 | 2016-03-16 |
| 1285046409 | Allison Dionne Harden Bostic | Nurse's Aide | 1557 Brown Rd, Hephzibah, GA 30815 | 2014-05-22 |
| 1568802353 | Daryl Wolf | Chiropractor | 2742 Willis Foreman Rd., Hephzabah, GA 30815 | 2013-06-26 |
| 1336467547 | Gussie Holmes Lawson | Adult Companion | 2412 Orchard Dr., Hephzibah, GA 30815 | 2010-05-12 |
| 1275864811 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2232 Montcrief Drive, Hephzibah, GA 30815 | 2010-01-21 |
| 1376878801 | Freeman's Second Time Around Healthcare Services | Home Health | 2716 Castletown Dr, Hephzibah, GA 30815 | 2009-10-16 |
| 1205028545 | Tonia Lynn Manley | Licensed Practical Nurse | 38th Street Building 38707, Fort Gordon, GA 30815 | 2007-08-10 |
| Find all providers in zip 30815 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013474915 | Community Service Board of East Central Georgia | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1715 Lawerence Rd, Hephzibah, GA 30815-4445 | 2019-02-27 |
| 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 |
| 1053683672 | Americanwork, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2082 Brown Rd, Hephzibah, GA 30815-4401 | 2012-01-27 |
| 1417229030 | Americanwork, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2577 Anthony Dejuan Pkwy, Hephzibah, GA 30815-5932 | 2012-01-27 |
| 1568530798 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3533 Stafford St, Hephzibah, GA 30815-6625 | 2006-12-04 |
| 1629146311 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3518 Snowden Dr, Hephzibah, GA 30815-6631 | 2006-12-01 |
| 1316015308 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2577 Lincolnton Pkwy, Hephzibah, GA 30815-5932 | 2006-11-30 |
| 1265509806 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 4114 Pinnacle Pines Ct, Hephzibah, GA 30815-6137 | 2006-11-29 |
| 1881966406 | Americanwork, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3004 Cromwell Ct, Hephzibah, GA 30815-6212 | 2012-01-27 |
| 1558632968 | Americanwork, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3533 Stafford St, Hephzibah, GA 30815-6625 | 2012-01-17 |
| Find all providers in HEPHZIBAH | ||||
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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.