NPIMap

Organization Active NPI

Devereux Georgia

  • Psychiatric Residential Treatment Facility
  • Kennesaw, GA
National Provider Identifier
1073997888
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Residential Treatment FacilityTaxonomy code 323P00000X
License
1352 Issued in GA
Legal business name
DEVEREUX GEORGIA
Practice address
1291 Stanley Rd NW
Kennesaw, GA 30152-4359
Phone
(770) 427-0147
Fax
(678) 303-5256
NPI assigned
Jul 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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

Authorized official

Name
Ms. Cathy Sears Huff, LCSW
Title
Clinical Therapist
Phone
(770) 427-0147

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Residential Treatment Facility 323P00000X 1352 GA Primary

Addresses

Primary practice location

1291 Stanley Rd NW
Kennesaw, GA 30152-4359

Mailing address

1291 Stanley Rd NW
Kennesaw, GA 30152-4359
Phone (770) 427-0147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Psychiatric residential treatment facility certification: CCN 11L003

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
DEVEREUX ADVANCED BEHAVIORAL HEALTH GEORGIA
Certification status
Active
Provider type (POS)
Psychiatric residential treatment facility
Participating since
Mar 19, 2009
Last certification
Dec 20, 2018
Beds
134
Ownership / control type
For profit – partnership
Facility address
1291 Stanley Road, NW
Kennesaw, GA 30152

National Provider Directory

National Provider Directory
Tax ID family
Devereux Florida331 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 2

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1073997888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1291 STANLEY RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524359",
            "telephone_number": "770-427-0147",
            "fax_number": "678-303-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1291 STANLEY RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524359",
            "telephone_number": "770-427-0147",
            "fax_number": "678-303-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVEREUX GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "HUFF",
        "authorized_official_first_name": "CATHY",
        "authorized_official_middle_name": "SEARS",
        "authorized_official_title_or_position": "CLINICAL THERAPIST",
        "authorized_official_telephone_number": "770-427-0147",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": "GA",
            "license": "1352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

Verify at the official NPI Registry.