EAST CENTRAL REGIONAL HOSPITAL
NPI 1053646166
Skilled Nursing Facility in Gracewood, GA

Active since October 07, 2009CLIA 11D0021712 · Waiver
100 MYRTLE BLVD, GRACEWOOD, GA 30812(706) 790-2042(706) 790-2476 Get Directions Write a Review

NPPES record last updated: May 20, 2015. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About East Central Regional Hospital NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EAST CENTRAL REGIONAL HOSPITAL (NPI 1053646166) is a healthcare organization registered as a skilled nursing facility in Gracewood, Georgia and active in the NPI registry since October 2009. The organization holds a CLIA Waiver certificate valid through November 30, 2027 and lists Paul Brock, Regional Hospital Administrator, as its authorized official.

NPPES Registry Identity

NPI1053646166
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameDEPARTMENT OF BEHAVIORAL HEALTH AND DEVELOPMENTAL DISABILITIES
Location Address100 MYRTLE BLVDGracewood, GA 30812-1500
Mailing Address100 Myrtle BlvdGracewood, GA 30812-1500 · (706) 790-2030 · Fax (706) 790-2025
Fax(706) 790-2476
Organization SubpartNo
Authorized OfficialPaul BrockRegional Hospital Administrator · (706) 790-2030
Enumeration DateOctober 7, 2009
Last NPPES UpdateMay 20, 2015
NPI 1053646166 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in GA · 1-121-694
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
100 MYRTLE BLVD, Gracewood, GA 30812

Other Names 1

Doing Business AsEast Central Regional Hospital

Other Identifiers 1

Medicaid000140709AGA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D0021712

East Central Regional Hospital Gracewood Campus · Gracewood, GA
Active · expires Nov 30, 2027
CLIA Number11D0021712
Laboratory TypeHospital
Certificate Effective DateDecember 1, 2025
Certificate Expiration DateNovember 30, 2027
Laboratory DirectorWilliam L. Hamilton
Laboratory Phone(706) 792-7793
Laboratory LocationEast Central Regional Hospital Gracewood Campus100 Myrtle Boulevard, Gracewood, GA 30812
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 17

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pediatrics
100 MYRTLE BLVD
GRACEWOOD, GA 30812
Intermediate Care Facility, Intellectual Disabilities
100 MYRTLE BLVD
AUGUSTA, GA 30812
Pharmacist
100 MYRTLE BLVD, DEPT OF PHARMACY
GRACEWOOD, GA 30812
Psychiatry & Neurology (Neurology)
100 MYRTLE BLVD, GRACEWOOD BLDG 103B
GRACEWOOD, GA 30812
Pediatrics
100 MYRTLE BLVD
GRACEWOOD, GA 30812
Dentist
100 MYRTLE BLVD
GRACEWOOD, GA 30812
Pediatrics
100 MYRTLE BLVD
GRACEWOOD, GA 30812
Pharmacist
100 MYRTLE BLVD, EAST CENTRAL REGIONAL HOSPITAL DEPT OF PHARMACY
GRACEWOOD, GA 30812

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Department Of Behavioral Health And Developmental Disabilities's NPI number?

The NPI number for Department Of Behavioral Health And Developmental Disabilities is 1053646166. It was assigned to this organization in the NPPES registry on October 7, 2009. The provider is doing business as East Central Regional Hospital.

Where is Department Of Behavioral Health And Developmental Disabilities located?

Department Of Behavioral Health And Developmental Disabilities is located at 100 Myrtle Blvd, Gracewood, GA 30812. The listed phone number is (706) 790-2042.

What is Department Of Behavioral Health And Developmental Disabilities's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Department Of Behavioral Health And Developmental Disabilities hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D0021712) is associated with this NPI, valid through November 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Department Of Behavioral Health And Developmental Disabilities was last updated on May 20, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.