Organization
HIGHLAND RIVERS COMMUNITY SERVICE BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELANIE A. DALLAS (CEO)
(706) 270-5000
Entity
Organization
Contact information
Practice address
1503 N TIBBS RD, DALTON, GA 30720-2915
(706) 270-5000
(706) 270-5111
Mailing address
1503 N TIBBS RD, DALTON, GA 30720-2915
(706) 270-5033
(706) 370-7749
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
332BC3200X
Customized Equipment (DME)
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023172350
SUBPART NPI
GA
01
—
1043373467
SUBPART NPI
GA
01
—
1083777650
SUBPART NPI
GA
01
—
1093878464
SUBPART NPI
GA
01
—
1093879827
SUBPART NPI
GA
01
—
1164585543
SUBPART NPI
GA
01
—
1174686620
SUBPART NPI
GA
01
—
1285798041
SUBPART NPI
GA
01
—
1538222971
SUBPART NPI
GA
01
—
1578626917
SUBPART NPI
GA
01
—
1629131214
SUBPART NPI
GA
01
—
1669536991
SUBPART NPI
GA
01
—
1689737033
SUBPART NPI
GA
01
—
1740343300
SUBPART NPI
GA
01
—
1861555450
SUBPART NPI
GA
01
—
1881758613
SUBPART NPI
GA
01
—
1912060088
SUBPART NPI
GA
05
—
300030794B
—
GA
Enumeration date
06/27/2005
Last updated
11/04/2022
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