OrganizationActive
Georgia Department of Human Resources
NPI 1316015308 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Hephzibah, GA
Provider details
- NPI number
- 1316015308
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Gail Jackson, Regional Hospital Administrator(706) 790-2030
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2577 Lincolnton Pkwy
Hephzibah, GA 30815-5932
Phone: (706) 790-2034
Approximate (ZIP-level) locationGet directions
Mailing address
100 Myrtle Blvd
Gracewood, GA 30812-1500
Other names (DBA / former)
- Doing business as
- Gracewood Community Services
Registry dates
- Enumerated
- 2006-11-30
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.