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SOUTH GEORGIA CSB NPI 1942374343


NPI Information

NPI: 1942374343
Provider Name: SOUTH GEORGIA CSB

Doing Business As: TIFT C&A OUTPATIENT SERVICES

Classification: Clinic/Center - 261QM0855X
Entity Type: Organization

Specialization: Adolescent and Children Mental Health

Address:
340 TIFTON ELDORADO ROAD
TIFTON, GA
ZIP 31794
Phone: (229) 391-2350
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SOUTH GEORGIA CSB is an adolescent and children mental health clinic center in Tifton, GA. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. SOUTH GEORGIA CSB NPI is 1942374343. The provider is registered as an organization entity type.
The provider Is Doing Business As Tift C&a Outpatient Services.

The provider's business location address is:

340 TIFTON ELDORADO ROAD
TIFTON, GA
ZIP 31794
Phone: (229) 391-2350
Fax: (229) 386-7099

The provider's authorized official is Charles R Powell .
The authorized official title is Chief Executive Officer and has the following contact phone number (229) 671-6101.

The enumeration date for this NPI number is 11/17/2006 and was last updated on 3/17/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM0855XClinic/CenterAdolescent and Children Mental HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GRP2255MEDICARE ID-TYPE UNSPECIFIEDGEORGIA
2777050079AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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