Destined Revisions, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DESTINED REVISIONS, LLC

Practice address

947 Bryant Hill Rd
Marshallville, GA 31057-3113

Phone

(678) 468-4880

NPI assigned

Feb 24, 2010

Last updated

Mar 16, 2017By 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

Miss Joy Junese Grier, B.S

Title

Owner

Phone

(678) 468-4880

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1266969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489622400000",
    "number": "1093037566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 E WESLEY CHAPEL WAY",
            "address_2": "STE 5",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300353430",
            "telephone_number": "678-468-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 BRYANT HILL RD",
            "city": "MARSHALLVILLE",
            "state": "GA",
            "postal_code": "310573113",
            "telephone_number": "678-468-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESTINED REVISIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-24",
        "last_updated": "2017-03-16",
        "status": "A",
        "authorized_official_last_name": "GRIER",
        "authorized_official_first_name": "JOY",
        "authorized_official_middle_name": "JUNESE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-468-4880",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "B.S"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Marshallville, GA
• Providers in Marshallville, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.