Grace Pch

LBN: Csb Of East Central Ga
Grace Pch is an health care organization with primary practice located at 2115 Ashley Dr , Augusta GA 30906-5085. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. Csb Of East Central Ga can be contacted via phone (706) 432-4858, or through Jessie, Wanda via phone (706) 432-4858.

Contact Information

Primary practice address
2115 Ashley Dr Augusta GA 30906-5085
Phone: (706) 432-4858
Fax: (706) 432-3780
Website:
Map and Directions
Authorized official contact:
Name: Jessie, Wanda
Phone: (706) 432-4858

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X

Profile Details

NPI number 1053642686
LBN Legal business name Csb Of East Central Ga
DBA Doing business as Grace Pch
Authorized official Jessie, Wanda
Entity Organization
Organization subpart 1 No
Enumeration date Jan 21st, 2010
Last updated Jan 21st, 2010 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053642686 NPPES
Georgia MEDICAID 000927693AA

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