NPIMap

Organization Active NPI

Pure Angels Home Care Services

  • In Home Supportive Care Agency
  • Stone Mountain, GA
National Provider Identifier
1104245034
Registry record updated Apr 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
044-R-1261 Issued in GA
Legal business name
PURE ANGELS HOME CARE SERVICES
Practice address
5300 Memorial Dr
Suite 134
Stone Mountain, GA 30083-3148
Phone
(404) 500-5425
Fax
(404) 500-5427
NPI assigned
Apr 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2014

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

Authorized official

Name
Mrs. Shirley J Breshers-Southwell
Title
Owner
Phone
(404) 500-5425

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X 044-R-1261 GA Primary

Addresses

Primary practice location

5300 Memorial Dr
Suite 134
Stone Mountain, GA 30083-3148

Mailing address

5300 Memorial Dr
Suite 134
Stone Mountain, GA 30083-3148
Phone (404) 500-5425

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396915200000",
    "number": "1104245034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 MEMORIAL DR",
            "address_2": "SUITE 134",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833148",
            "telephone_number": "404-500-5425",
            "fax_number": "404-500-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 MEMORIAL DR",
            "address_2": "SUITE 134",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833148",
            "telephone_number": "404-500-5425",
            "fax_number": "404-500-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE ANGELS HOME CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-08",
        "last_updated": "2014-04-08",
        "status": "A",
        "authorized_official_last_name": "BRESHERS-SOUTHWELL",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-500-5425",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "044-R-1261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2014; 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.