Hattie Clay Oliver PCH

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

PCH005570 Issued in GA

Legal business name

HATTIE CLAY OLIVER PCH

Practice address

418 Vinings Vintage Cir
Mableton, GA 30126-7208

Phone

(770) 575-0582

Fax

(404) 756-4894

NPI assigned

Dec 2, 2011

Organization subpart

No

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

Authorized official

Name

Mr. James C Ford

Title

Ceo

Phone

(770) 575-0582

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1322784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1104194307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 MADISON GREEN LN SW",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301262154",
            "telephone_number": "770-575-0582",
            "fax_number": "404-756-4894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 VININGS VINTAGE CIR",
            "city": "MABLETON",
            "state": "GA",
            "postal_code": "301267208",
            "telephone_number": "770-575-0582",
            "fax_number": "404-756-4894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HATTIE CLAY OLIVER PCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-02",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-575-0582",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "PCH005570",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "PCH005570",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Mableton, GA
• Providers in Mableton, GA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.