NPIMap

Organization Active NPI

Beth'El Personal Care Home

  • Assisted Living Facility (Behavioral Disturbances)
  • Loganville, GA
National Provider Identifier
1104118108
Registry record updated May 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X
License
756428113A Issued in GA
Legal business name
BETH'EL PERSONAL CARE HOME
Practice address
4327 Webb Meadows Dr
Loganville, GA 30052-7579
Phone
(770) 736-6439
Fax
(678) 609-5540
NPI assigned
May 9, 2011
Last updated
May 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2011

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

Authorized official

Name
Ms. Abosede Adetutu Oshinubi, RD, LD
Title
Director
Phone
(770) 736-6439

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Behavioral Disturbances) 3104A0630X 756428113A GA Primary

Addresses

Primary practice location

4327 Webb Meadows Dr
Loganville, GA 30052-7579

Mailing address

4327 Webb Meadows Dr
Loganville, GA 30052-7579
Phone (770) 736-6439

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1304899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304899200000",
    "number": "1104118108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4327 WEBB MEADOWS DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300527579",
            "telephone_number": "770-736-6439",
            "fax_number": "678-609-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4327 WEBB MEADOWS DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300527579",
            "telephone_number": "770-736-6439",
            "fax_number": "678-609-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BETH'EL PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-09",
        "last_updated": "2011-05-09",
        "status": "A",
        "authorized_official_last_name": "OSHINUBI",
        "authorized_official_first_name": "ABOSEDE",
        "authorized_official_middle_name": "ADETUTU",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "770-736-6439",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RD, LD"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "GA",
            "license": "756428113A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.