Organization
COBB COUNTY COMMUNITY SERVICES BOARD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOD CITRON (CEO)
(770) 429-5000
Entity
Organization
Contact information
Practice address
2051 GREENRIDGE RD SE, SMYRNA, GA 30080-1116
(770) 434-7911
Mailing address
3830 S COBB DR SE, SUITE 300, SMYRNA, GA 30080-5532
(770) 429-5000
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00599695A
—
GA
05
—
00603556A
—
GA
05
—
00603556B
—
GA
05
—
00961705B
—
GA
Enumeration date
02/13/2007
Last updated
08/22/2020
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