Organization
HIGHLAND RIVERS CSB
Active
Parent organization
HIGHLAND RIVERS CENTER, CSB
Other names
Highland Rivers Womens Outreach - TANF
Organization subpart
Yes
Provider details
NPI number
Legal business name
HIGHLAND RIVERS CENTER, CSB
Authorized official
MR. JASON BEARDEN (CEO)
(706) 270-5000
Entity
Organization
Contact information
Practice address
6 MATHIS DRIVE, NW, SUITE A, ROME, GA 30165-1242
(706) 291-7201
(706) 291-7198
Mailing address
1401 APPLEWODD DRIVE, SUITE 1, DALTON, GA 30720-2699
(706) 270-5002
(706) 370-7749
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
GA
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000759448P
—
GA
01
—
1447256243
ORGANIZATION MASTER NPI
GA
Enumeration date
12/18/2006
Last updated
09/20/2011
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