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SOUTH GEORGIA CSB NPI 1942374350


NPI Information

NPI: 1942374350
Provider Name: SOUTH GEORGIA CSB

Doing Business As: COOK DD SERVICES

Classification: Clinic/Center - 261QD1600X
Entity Type: Organization

Specialization: Developmental Disabilities

Address:
203 INDUSTRIAL PARK DRIVE
ADEL, GA
ZIP 31620
Phone: (229) 896-7994
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SOUTH GEORGIA CSB is a developmental disabilities clinic center in Adel, GA. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). SOUTH GEORGIA CSB NPI is 1942374350. The provider is registered as an organization entity type.
The provider Is Doing Business As Cook Dd Services.

The provider's business location address is:

203 INDUSTRIAL PARK DRIVE
ADEL, GA
ZIP 31620
Phone: (229) 896-7994
Fax: (229) 896-3709

The provider's authorized official is Sue Gupton .
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 12/15/2008.


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
1261QD1600XClinic/CenterDevelopmental DisabilitiesYes

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
1000607032AMEDICAIDGEORGIA
2000607032WMEDICAIDGEORGIA

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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