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Organization
CSB OF EAST CENTRAL GA
Active
Organization
CSB OF EAST CENTRAL GA
Active
Other names
JACKIE WEST
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA JESSIE (BILLING MANAGER)
(706) 432-4858
Entity
Organization
Contact information
Practice address
2006 COUNTRY PLACE DR, AUGUSTA, GA 30906-8732
(706) 432-4858
(706) 432-3780
Mailing address
3421 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 432-4858
(706) 432-3780
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
GA
Other
Enumeration date
04/07/2010
Last updated
04/07/2010
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