Easter Seals Southern Georgia Inc., NPI 1124085451
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Albany, GA, US

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NPI number: what is it?

The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...

NPI 1124085451
NPI Entity Type Organization
Provider Name Easter Seals Southern Georgia Inc.
Enumeration Date September 30, 2009
Last Update Date September 30, 2009
Certification Date September 30, 2009
Provider Location Address 1906 Palmyra Rd, Albany, GA, US
Provider Mailing Address 1906 Palmyra Rd, Albany, GA, US, 317011575
Gender Male
Is Sole Proprietor? No
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Organization Official

Official Name Matt Hatcher
Official Position COO
Phone 229-439-7061

Primary Taxonomy

Taxonomy Code

320900000X

Taxonomy Name Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Classification

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

Group

Residential Treatment Facilities

License No. 047-R-0011
License State GA
Description A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Business Address

Easter Seals Southern Georgia Inc.
1906 Palmyra Rd

Albany, GA, US

Phone: 229-439-7061
Fax: 229-439-2824

Mailing Address

Easter Seals Southern Georgia Inc.
1906 Palmyra Rd
Albany, GA, US
ZIP 317011575
Phone: 229-439-7061
Fax: 229-439-2824

Secondary Taxonomies

Taxonomy Code Group Classification License No. State Primary?

251C00000X

Agencies

Day Training, Developmentally Disabled Services

047-R-0011 GA No

332B00000X

Suppliers

Durable Medical Equipment & Medical Supplies

047-R-0011 GA No

385HR2060X

Respite Care Facility

Respite Care

047-R-011 GA No

Other Identifiers

Identifier Identifier State Identifier Issuer Type/Code
000551405AW GA MEDICAID 05
000551405BG GA MEDICAID 05
000551405BN GA MEDICAID 05
000693844O GA MEDICAID 05
000551405AZ GA MEDICAID 05
000551405BA GA MEDICAID 05
000551405BM GA MEDICAID 05
000693844C GA MEDICAID 05
000551405AK GA MEDICAID 05
000551405AX GA MEDICAID 05
000551405BB GA MEDICAID 05
000551405BE GA MEDICAID 05
000551405BL GA MEDICAID 05
000551405BO GA MEDICAID 05
000551405AY GA MEDICAID 05
000693844N GA MEDICAID 05
000693844W GA MEDICAID 05
000551405BC GA MEDICAID 05
000551405D GA MEDICAID 05
000639844T GA MEDICAID 05
000693844V GA MEDICAID 05
000551405A GA MEDICAID 05
000551405F GA MEDICAID 05
000551405J GA MEDICAID 05
000693844Q GA MEDICAID 05
000551405BF GA MEDICAID 05
000551405BH GA MEDICAID 05
000693844S GA MEDICAID 05
000693844X GA MEDICAID 05
000520528A GA MEDICAID 05
000551405AI GA MEDICAID 05
000551405BI GA MEDICAID 05
000693844B GA MEDICAID 05

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NPI Name Taxonomy Address

1386307460

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1235277799

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1841927407

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Organization

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1992237465

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Organization

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1164612370

DR. DO Colette Devona Bullock

Individual

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1356959522

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1356999130

LDO Anna Mccaskill

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1710602180

MSHA, BSN, RN, CPN Madlina Jonassaint

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1508319856

FNP-C Sandra Nicole Mcneal

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Mc Rae, GA

1093046005

Georgia Department Of Behavioral Health And Developmental Disabilities

Organization

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1780309146

Comfort Of Care Llc

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1801511258

Atlanta Hand Therapy, Llc

Organization

Hand Occupational Therapist

6115 Peachtree Dunwoody Rd Ste 210

Sandy Springs, GA

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