Ecrh-Gracewood Developmental Center

LBN: Georgia Department Of Human Resources
Ecrh-Gracewood Developmental Center is an health care organization with primary practice located at 100 Myrtle Blvd , Augusta GA 30812-1500. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded, which is considered as the primary health care specialty. Georgia Department Of Human Resources can be contacted via phone (706) 790-2030, or through Jackson, Gail C via phone (706) 790-2030.

Contact Information

Primary practice address
100 Myrtle Blvd Augusta GA 30812-1500
Phone: (706) 790-2030
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Jackson, Gail C Doctor of Medicine (MD)
Phone: (706) 790-2030

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Intermediate Care Facility, Mentally Retarded 315P00000X 2121792 Georgia

Profile Details

NPI number 1083782288
LBN Legal business name Georgia Department Of Human Resources
DBA Doing business as Ecrh-Gracewood Developmental Center
Authorized official Jackson, Gail C Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 4th, 2006
Last updated Aug 22nd, 2020 - about 4 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 1083782288 NPPES
Georgia MEDICAID 00141204A

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