Georgia Department Of Human Resources
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Augusta, GA. Organization (NPI-2).
Details
- NPI
- 1366510067
- Entity type
- Organization (NPI-2)
- Legal business name
- Georgia Department Of Human Resources
- Organization subpart
- No
- Enumeration date
- Dec 1, 2006
- Last updated
- Aug 22, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320900000X | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | 121013811 | GA | Yes |
Other names
- Gracewood Community Services (Doing Business As)
Practice location
2311 Mura DrAugusta, GA 30906-4819
Phone 706-790-2034
Mailing address
100 Myrtle BlvdGracewood, GA 30812-1500
Phone 706-790-2030
Authorized official
Gail C Jackson
Regional Hospital Administrator
7067902030
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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