Provider Demographics
NPI:1952066292
Name:ALBANY AREA CSB
Entity Type:Organization
Organization Name:ALBANY AREA CSB
Other - Org Name:ACT COTTON MILL
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:229-430-4005
Mailing Address - Street 1:PO BOX 1988
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31702-1988
Mailing Address - Country:US
Mailing Address - Phone:229-518-1876
Mailing Address - Fax:
Practice Address - Street 1:509 11TH AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31701-1627
Practice Address - Country:US
Practice Address - Phone:229-349-6707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALBANY AREA COMMUNITY SERVICE BOARD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-11-02
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)