Haven Heart's Community Development Center, Inc.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

HAVEN HEART'S COMMUNITY DEVELOPMENT CENTER, INC.

Doing business as

Augusta Community Resource Center

Practice address

5604 Wendy Bagwell Parkway
Suite 211
Hiram, GA 30141-7814

Phone

(770) 485-2202

Fax

(770) 575-0456

NPI assigned

May 11, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Sonja Yvette Hopkins

Title

Executive Director

Phone

(770) 485-2202

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Augusta Community Resource Center Doing business as

Locations

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1043425416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 WENDY BAGWELL PARKWAY",
            "city": "HIRIAM",
            "state": "GA",
            "postal_code": "301417814",
            "telephone_number": "770-485-2202",
            "fax_number": "770-575-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 WENDY BAGWELL PARKWAY",
            "address_2": "SUITE 211",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301417814",
            "telephone_number": "770-485-2202",
            "fax_number": "770-575-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAVEN HEART'S COMMUNITY DEVELOPMENT CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "HOPKINS",
        "authorized_official_first_name": "SONJA",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "770-485-2202",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040676383A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Augusta Community Resource Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mental Health Counselor in Hiram, GA
• Providers in Hiram, GA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.