Organization
EASTER SEALS SOUTHERN GEORGIA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATT HATCHER (COO)
(229) 439-7061
Entity
Organization
Contact information
Practice address
1906 PALMYRA RD, ALBANY, GA 31701-1575
(229) 439-7061
(229) 439-2824
Mailing address
1906 PALMYRA RD, ALBANY, GA 31701-1575
(229) 439-7061
(229) 439-2824
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
047-R-0011
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000551405AB
—
GA
05
—
000551405AC
—
GA
05
—
000551405AD
—
GA
05
—
000551405AE
—
GA
05
—
000551405AI
—
GA
05
—
000551405AK
—
GA
05
—
000551405AL
—
GA
05
—
000551405AM
—
GA
05
—
000551405AN
—
GA
05
—
000551405AO
—
GA
05
—
000551405AT
—
GA
05
—
000551405AU
—
GA
05
—
000551405AV
—
GA
05
—
000551405AW
—
GA
05
—
000551405AX
—
GA
05
—
000693844I
—
GA
05
—
000693844J
—
GA
05
—
000693844K
—
GA
05
—
000693844L
—
GA
05
—
000693844M
—
GA
05
—
000693844N
—
GA
05
—
000693844Q
—
GA
05
—
000693844S
—
GA
05
—
000693844T
—
GA
05
—
000693844U
—
GA
05
—
000693844V
—
GA
05
—
000693844W
—
GA
Enumeration date
09/14/2011
Last updated
01/24/2021
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