NPIViewer - Provider NPI 1588735252

NPI:	1588735252
Name:	PINELAND AREA COMMUNITY SERVICES BOARD
Entity type:	Organization
Organization Name:	PINELAND AREA COMMUNITY SERVICES BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:	INTERIM CEO
Authorized Official - Prefix:	DR
Authorized Official - First Name:	CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:	CONE-DEKLE
Authorized Official - Suffix:
Authorized Official - Credentials:	PHD
Authorized Official - Phone:	912-764-6906
Mailing Address - Street 1:	PO BOX 745
Mailing Address - Street 2:
Mailing Address - City:	STATESBORO
Mailing Address - State:	GA
Mailing Address - Zip Code:	30459-0745
Mailing Address - Country:	US
Mailing Address - Phone:	912-764-6906
Mailing Address - Fax:	912-764-6466
Practice Address - Street 1:	11 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:	STATESBORO
Practice Address - State:	GA
Practice Address - Zip Code:	30458-5306
Practice Address - Country:	US
Practice Address - Phone:	912-764-9868
Practice Address - Fax:	912-764-5066
EIN:	<UNAVAIL>
Is Organization Subpart?:	No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:	2006-11-13
Last Update Date:	2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:

Primary?	Code	Type	Classification	Specialization
Yes	251S00000X	Agencies	Community/Behavioral Health

State	Identifier ID	ID Type
GA	000599343O	Medicaid
GA	000599343Z	Medicaid
GA	000622542AD	Medicaid
GA	000622542BB	Medicaid
GA	000622542J	Medicaid
GA	000720068D	Medicaid
GA	000981505A	Medicaid
GA	000622542AJ	Medicaid
GA	000622542AQ	Medicaid
GA	000622542AR	Medicaid
GA	000622542AV	Medicaid
GA	000622542B	Medicaid
GA	000720068A	Medicaid
GA	000720068K	Medicaid
GA	000720068O	Medicaid
GA	000599343Y	Medicaid
GA	000622542G	Medicaid
GA	000720068B	Medicaid
GA	000720068M	Medicaid
GA	000599343B	Medicaid
GA	000622542A	Medicaid
GA	000722147B	Medicaid
GA	000599343C	Medicaid
GA	000599343D	Medicaid
GA	000599343X	Medicaid
GA	000622542AH	Medicaid
GA	000622542AP	Medicaid
GA	000622542BA	Medicaid
GA	000599343A	Medicaid
GA	000599343AA	Medicaid
GA	000599343G	Medicaid
GA	000622542AI	Medicaid
GA	000622542AO	Medicaid
GA	000622542AU	Medicaid
GA	000720068L	Medicaid