Terrell's Personal Care Home, Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

TERRELL'S PERSONAL CARE HOME, INC

Doing business as

T and A's Personal Care Home

Practice address

5100 Atlanta Hwy
5150 Atlanta Highway
Bogart, GA 30622-2109

Phone

(706) 338-5091

Fax

(866) 615-7091

NPI assigned

Sep 13, 2011

Last updated

Sep 13, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Andrick Terrell-Moon

Title

Program Manager

Phone

(706) 338-5091

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• T and A's Personal Care Home Doing business as

Locations

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

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1083996292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 BARRINGTON DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053580",
            "telephone_number": "706-338-5091",
            "fax_number": "866-615-7091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 ATLANTA HWY",
            "address_2": "5150 ATLANTA HIGHWAY",
            "city": "BOGART",
            "state": "GA",
            "postal_code": "306222109",
            "telephone_number": "706-338-5091",
            "fax_number": "866-615-7091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERRELL'S PERSONAL CARE HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "TERRELL-MOON",
        "authorized_official_first_name": "ANDRICK",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "706-338-5091",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "404716841B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "233656728A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "T and A's Personal Care Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Developmentally Disabled Services Day Training Agency in Bogart, GA
• Providers in Bogart, GA by specialty
• Developmentally Disabled Services Day Training Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; 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.