Annette Davis Pch

LBN: Csb Of East Central Ga
Annette Davis Pch is an health care organization with primary practice located at 3015 Manchester Dr , Hephzibah GA 30815-7166. 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
3015 Manchester Dr Hephzibah GA 30815-7166
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 1346565926
LBN Legal business name Csb Of East Central Ga
DBA Doing business as Annette Davis Pch
Authorized official Jessie, Wanda
Entity Organization
Organization subpart 1 No
Enumeration date Apr 7th, 2010
Last updated Apr 7th, 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 1346565926 NPPES
Georgia MEDICAID 000927693AP

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