# CSB OF EAST CENTRAL GA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ANNETTE DAVIS PCH
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346565926
- **Authorized official:** WANDA JESSIE (BILLING MANAGER)
- **Authorized official phone:** (706) 432-4858

## Contact information

- **Practice address:** 3015 MANCHESTER DR, HEPHZIBAH, GA 30815-7166
- **Practice address phone:** (706) 432-4858
- **Practice address fax:** (706) 432-3780
- **Mailing address:** 3421 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
- **Mailing address phone:** (706) 432-4858
- **Mailing address fax:** (706) 432-3780

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 04/07/2010
- **Last updated:** 04/07/2010