OrganizationActive
Southern Community Services Inc
NPI 1417112707 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Douglas, GA
Provider details
- NPI number
- 1417112707
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Lisa Moore, Manager(912) 393-3466
- License
- 034-01-019-8 (GA)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 034-01-019-8 (GA)
Residential Treatment Facilities
Profile Score
Detailed profile(87/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 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
315 S. Gaskin Ave
Douglas, GA 31533
Phone: (912) 393-3466
Fax: (912) 393-1103
Street-level locationGet directions
Mailing address
315 S. Gaskin Ave
Douglas, GA 31533
Registry dates
- Enumerated
- 2008-07-25
- Last updated
- 2008-07-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.