Southern Group Homes, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SOUTHERN GROUP HOMES, LLC

Practice address

5450 Platte Dr
Ellenwood, GA 30294-6667

Phone

(770) 472-9113

NPI assigned

Aug 13, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jeffrey Charles Chastain

Title

Owner

Phone

(864) 979-5397

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281657600000",
    "number": "1033424171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 228",
            "city": "EASLEY",
            "state": "SC",
            "postal_code": "296410228",
            "telephone_number": "770-472-9113",
            "fax_number": "770-216-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 PLATTE DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946667",
            "telephone_number": "770-472-9113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN GROUP HOMES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-13",
        "last_updated": "2010-08-13",
        "status": "A",
        "authorized_official_last_name": "CHASTAIN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "864-979-5397"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.