Provider Demographics
NPI:1689807034
Name:COMMUNITY GROWTH ENTERPRISES INC.
Entity Type:Organization
Organization Name:COMMUNITY GROWTH ENTERPRISES INC.
Other - Org Name:CGE TRANSPORTATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:478-994-0111
Mailing Address - Street 1:48 EAST JOHNSTON STREET
Mailing Address - Street 2:P.O.BOX 23
Mailing Address - City:FORSYTH
Mailing Address - State:GA
Mailing Address - Zip Code:31029
Mailing Address - Country:US
Mailing Address - Phone:478-994-0111
Mailing Address - Fax:478-994-2488
Practice Address - Street 1:48 E JOHNSTON ST
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:GA
Practice Address - Zip Code:31029-2207
Practice Address - Country:US
Practice Address - Phone:478-994-0111
Practice Address - Fax:478-994-2488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA500811343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)