NPIMap

Organization Active NPI

Mildred's Homeplace III

Doing business as The HomePlace Shelter Inc.

  • Community Based Hospice Care Agency
  • Thomasville, GA
National Provider Identifier
1073847703
Registry record updated Sep 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
MILDRED'S HOMEPLACE III
Doing business as
The HomePlace Shelter Inc.
Practice address
357 A & B Shoreline Drive
Thomasville, GA 31792-4608
Phone
(229) 551-0695
Fax
(229) 551-0694
NPI assigned
Sep 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2009

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

Authorized official

Name
Mrs. Nancy Lee Mitchell
Title
Administrator
Phone
(229) 228-1985

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X GA Primary
Non-emergency Medical Transport (VAN) 343900000X GA

Addresses

Primary practice location

357 A & B Shoreline Drive
Thomasville, GA 31792-4608

Mailing address

612 East Clay Street
Thomasville, GA 31792-4608
Phone (229) 551-0695

Other identifiers 1

IdentifierTypeStateIssuer
136-01-096-1OtherGAPERSONALCARE HOME

Other names 1

  • The HomePlace Shelter Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
The Homeplace Shelter Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1254182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254182400000",
    "number": "1073847703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 EAST CLAY STREET",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924608",
            "telephone_number": "229-551-0695",
            "fax_number": "229-551-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "357 A & B SHORELINE DRIVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924608",
            "telephone_number": "229-551-0695",
            "fax_number": "229-551-0694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILDRED'S HOMEPLACE III",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-29",
        "last_updated": "2009-09-29",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "229-228-1985",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONALCARE HOME",
            "identifier": "136-01-096-1",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The HomePlace Shelter Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; 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.