NPIMap

Organization Active NPI

Eastlake Arbor Health Care, Inc.

  • Skilled Nursing Facility
  • Decatur, GA
National Provider Identifier
1083680094
Registry record updated Aug 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
10441435 Issued in GA
Legal business name
EASTLAKE ARBOR HEALTH CARE, INC.
Practice address
304 Fifth Ave
Decatur, GA 30030-4812
Phone
(404) 373-6231
Fax
(404) 373-6813
NPI assigned
Feb 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2008

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

Authorized official

Name
Mr. Lee Karschner
Title
Director of Operations
Phone
(770) 939-8720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 10441435 GA Primary

Addresses

Primary practice location

304 Fifth Ave
Decatur, GA 30030-4812

Mailing address

304 Fifth Ave
Decatur, GA 30030-4812
Phone (404) 373-6231

Other identifiers 1

IdentifierTypeStateIssuer
000140137AMedicaidGA

Other names 1

  • East Lake Arbor Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219017600000",
    "number": "1083680094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 FIFTH AVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300304812",
            "telephone_number": "404-373-6231",
            "fax_number": "404-373-6813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 FIFTH AVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300304812",
            "telephone_number": "404-373-6231",
            "fax_number": "404-373-6813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTLAKE ARBOR HEALTH CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2008-08-18",
        "status": "A",
        "authorized_official_last_name": "KARSCHNER",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "770-939-8720",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "10441435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000140137A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Lake Arbor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.