OrganizationActive
South Georgia Csb
NPI 1578636817 · Emotionally Disturbed Childrens' Residential Treatment Facility · Valdosta, GA
Provider details
- NPI number
- 1578636817
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Sue Gupton, Chief Executive Officer
Practice location
4401 Willow Wood Gate
Valdosta, GA 31602-6709
Phone: (229) 242-4734
Fax: (229) 242-2984
Mailing address
4401 Willow Wood Gate
Valdosta, GA 31602-6709
Registry dates
- Enumerated
- 2006-11-16
- 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.