Organization Active NPI

K&R Glowing Pride Residential Services of Georgia

  • Community/Behavioral Health Agency
  • Conyers, GA
National Provider Identifier
1114707924
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
K&R GLOWING PRIDE RESIDENTIAL SERVICES OF GEORGIA
Practice address
871 Cowan Rd SE
Conyers, GA 30094-4115
Phone
(317) 517-7688
NPI assigned
Oct 2, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Authorized official

Name
Ms. Keyana RiceNPI 1003620162
Title
Owner
Phone
(317) 517-7688

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

871 Cowan Rd SE
Conyers, GA 30094-4115

Mailing address

2819 Matera Dr
Saint Cloud, FL 34771-9155
Phone (317) 517-7688

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1114707924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2819 MATERA DR",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347719155",
            "telephone_number": "317-517-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "871 COWAN RD SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300944115",
            "telephone_number": "317-517-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K&R GLOWING PRIDE RESIDENTIAL SERVICES OF GEORGIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-09-30",
        "status": "A",
        "authorized_official_last_name": "RICE",
        "authorized_official_first_name": "KEYANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-517-7688",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.