South Georgia Csb in Valdosta - Residential Treatment Facility, Emotionally Disturbed Children
South Georgia Csb - NPI 1578636817
South Georgia Csb is a Residential Treatment Facility, Emotionally Disturbed Children in Valdosta, Georgia. South Georgia Csb practices all healthcare services and medical treatments related to Residential Treatment Facility, Emotionally Disturbed Children. The NPI Number for South Georgia Csb is 1578636817. The last update date is 2020-08-22.
South Georgia Csb's current location address is 4401 Willow Wood Gate, Valdosta, Georgia. You can contact this provider via phone number 2292424734 and fax number 2292422984. The mailing address for South Georgia Csb is 4401 Willow Wood Gate, Valdosta, Georgia. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | South Georgia Csb |
|---|---|
| Address | 4401 Willow Wood Gate, Valdosta, Georgia |
| Phone Number | 2292424734 |
| Fax Number | 2292422984 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CHIEF EXEC |
|---|---|
| Authorized Official Name | Gupton Sue |
| Telephone Number | 2292452379 |
NPI Number Detail
| NPI Number | 1578636817 |
|---|---|
| Provider Enumeration Date | 2006-11-16 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 4401 Willow Wood Gate |
|---|---|
| City | Valdosta |
| State | Georgia (GA) |
| Post Code | 316026709 |
| Phone Number | 2292424734 |
| Fax Number | 2292422984 |
Provider's Primary Taxonomy Detail
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
|---|---|
| Taxonomy | 322D00000X |
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Definition: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. |
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What is the unique 10-digit identifier code issued to South Georgia Csb by the Centers for Medicare & Medicaid Services?
The South Georgia Csb has been assigned the NPI (National Provider Identifier) 1578636817 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Can you provide the South Georgia Csb's physical address?
The South Georgia Csb is physically located at 4401 Willow Wood Gate, in the city of Valdosta, GA, with the postal code 316026709.
What is South Georgia Csb's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for South Georgia Csb is Residential Treatment Facility, Emotionally Disturbed Children, and the taxonomy classification code that categorizes this area of expertise is 322D00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1578636817 to South Georgia Csb?
The South Georgia Csb received its 1578636817 assignment from the Centers for Medicare & Medicaid Services on 2006-11-16.
As of what date were the details related to South Georgia Csb most recently updated or revised?
The information pertaining to South Georgia Csb, including its address, specialty, and other relevant details, was last updated or revised on 2020-08-22.