Sovereign Healthcare Services, Inc.

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

004876 Issued in GA

Legal business name

SOVEREIGN HEALTHCARE SERVICES, INC.

Practice address

6015 Waters Edge TRL
Roswell, GA 30075-8275

Phone

(360) 989-6710

NPI assigned

Jun 11, 2015

Last updated

Jun 11, 2015By 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

Lachell M Mensing, MS, OTR/LNPI 1215177720

Title

Ceo/President

Phone

(360) 989-6710

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lachell Marie Mensing, MS, OTR/L

  • Pediatric Occupational Therapist
  • Roswell, GA
  • NPI 1215177720
  Authorized official Same address or phone

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1093196594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 WATERS EDGE TRL",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300758275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 WATERS EDGE TRL",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300758275",
            "telephone_number": "360-989-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN HEALTHCARE SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "MENSING",
        "authorized_official_first_name": "LACHELL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "360-989-6710",
        "authorized_official_credential": "MS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "GA",
            "license": "004876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; 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.