Organization
CSB OF EAST CENTRAL GA
Active
Other names
Jacobs HH
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER DUBOSE (RESIDENTIAL MANAGER)
(706) 432-4928
Entity
Organization
Contact information
Practice address
4008 RAMSWOOD DR, HEPHZIBAH, GA 30815-5849
(762) 221-1090
(706) 432-3861
Mailing address
3421 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 432-4928
(706) 432-3861
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/15/2017
Last updated
02/15/2017
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