Temple Personal Care Home LLC

Primary specialty

Nursing Home AdministratorTaxonomy code 376G00000X

Legal business name

TEMPLE PERSONAL CARE HOME LLC

Practice address

838 Shadybrook Dr NE
Marietta, GA 30066-6215

Phone

(404) 660-1571

NPI assigned

Sep 8, 2019

Organization subpart

No

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

Authorized official

Name

Marie Gertrude Bitota Tshimanga

Title

Director

Phone

(404) 660-1571

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1567900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567900800000",
    "number": "1083263545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 SHADYBROOK DR NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666215",
            "telephone_number": "404-660-1571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 SHADYBROOK DR NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300666215",
            "telephone_number": "404-660-1571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEMPLE PERSONAL CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-08",
        "last_updated": "2019-09-08",
        "status": "A",
        "authorized_official_last_name": "TSHIMANGA",
        "authorized_official_first_name": "MARIE GERTRUDE",
        "authorized_official_middle_name": "BITOTA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "404-660-1571"
    },
    "taxonomies": [
        {
            "code": "376G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nursing Home Administrator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Home Administrator in Marietta, GA
• Providers in Marietta, GA by specialty
• Nursing Home Administrator in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2019; 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.