Organization
HIGHLAND RIVERS COMMUNITY SERVICE BOARD
Active
Organization
HIGHLAND RIVERS COMMUNITY SERVICE BOARD
Active
Parent organization
HIGHLAND RIVERS COMMUNITY SERVICE BOARD
Organization subpart
Yes
Provider details
NPI number
Legal business name
HIGHLAND RIVERS COMMUNITY SERVICE BOARD
Authorized official
MR. JASON BEARDEN (CEO)
(706) 270-5000
Entity
Organization
Contact information
Practice address
1 WOODBINE AVE NW, ROME, GA 30165-2397
(706) 314-0019
(706) 314-0343
Mailing address
1401 APPLEWOOD DR, SUITE 1, DALTON, GA 30720-2699
(706) 270-5002
(706) 270-5111
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
GA
251S00000X
Community/Behavioral Health Agency
—
GA
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
GA
332BC3200X
Customized Equipment (DME)
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000601807AB
—
GA
Enumeration date
09/20/2011
Last updated
04/03/2012
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