MEDICARE: OCONEE COMMUNITY SERVICE BOARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1306032230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OCONEE COMMUNITY SERVICE BOARD

Provider Business Mailing Address
First Line	:	PO BOX 1827
Second Line	:
City	:	MILLEDGEVILLE
State	:	GA
Zip	:	31059-1827
Country	:	US
Telephone Number	:	478-445-4817
Fax Number	:

Provider Business Practice Location Address
First Line	:	1371 ORCHARD HILL RD
Second Line	:
City	:	MILLEDGEVILLE
State	:	GA
Zip	:	31061-2551
Country	:	US
Telephone Number	:	478-445-5120
Fax Number	:

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	JENNIFER B GHEESLING
Credential	:
Telephone Number	:	478-445-4971

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	01/14/2020

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Directions to “OCONEE COMMUNITY SERVICE BOARD ” Practice Location

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