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NPI Code Detail

MEDICARE: DOUGLAS COUNTY COMMUNITY SERVICES BOARD

MEDICARE: DOUGLAS COUNTY COMMUNITY SERVICES 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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1992845929
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOUGLAS COUNTY COMMUNITY SERVICES BOARD
Provider Business Mailing Address
First Line : 3830 S COBB DR SE
Second Line : SUITE 300
City : SMYRNA
State : GA
Zip : 30080-5532
Country : US
Telephone Number : 770-429-5000
Fax Number :
Provider Business Practice Location Address
First Line : 7205 NORTH COUNTY LINE ROAD
Second Line :
City : LITHIA SPRINGS
State : GA
Zip : 30122-2133
Country : US
Telephone Number : 770-429-5000
Fax Number :
Authorized Official
Title or Position : CEO
Name : TOD CITRON
Credential :
Telephone Number : 770-429-5000
Provider Enumeration Date : 02/07/2007
Last Update Date : 08/22/2020

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Directions to “DOUGLAS COUNTY COMMUNITY SERVICES BOARD ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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