NPIMap

Organization Active NPI

Respite Retreat, Inc.

  • Adolescent and Children Mental Health Clinic/Center
  • Blairsville, GA
National Provider Identifier
1073038063
Registry record updated Aug 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
RESPITE RETREAT, INC.
Practice address
1256 Old Gum Log Rd
Blairsville, GA 30512-2065
Phone
(706) 781-3155
NPI assigned
Aug 10, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2017

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

Authorized official

Name
Christine Owen, MANPI 1558784587
Title
Officer
Phone
(706) 781-3155

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary
Emotionally Disturbed Childrens' Residential Treatment Facility 322D00000X
Child Mental Illness Respite Care 385HR2055X

Addresses

Primary practice location

1256 Old Gum Log Rd
Blairsville, GA 30512-2065

Mailing address

PO Box 2703
Blairsville, GA 30514-2703
Phone (706) 897-4237

National Provider Directory

National Provider Directory

Locations

1256 Old Gum Log Rd
Blairsville, GA 30512
Phone (706) 781-3155

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502323200000",
    "number": "1073038063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2703",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305142703",
            "telephone_number": "706-897-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1256 OLD GUM LOG RD",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305122065",
            "telephone_number": "706-781-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESPITE RETREAT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-10",
        "last_updated": "2017-08-10",
        "status": "A",
        "authorized_official_last_name": "OWEN",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "706-781-3155",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blairsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2017; 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.