Active NPI
K&R Glowing Pride Residential Services of Georgia
- Community/Behavioral Health Agency
- Conyers, GA
National Provider Identifier
1114707924
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Keyana Rice
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryPractitioners & 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.
-
- Driver
- Carmel, IN
- NPI 1003620162
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
- Jsa Dental Associates Conyers PC (Honey Creek Dental)
- Julianne Adams Birt, MD, LLC (Radiant Women's Health)
- Andrea N Jump, D.C.
- Susan B Jung, LPC
- Michele Lee Junger, DDS
- Merlyn J Kaalla, D.O.
- Amisha Atul Kadiwar, MD
- Kaiser Foundation Health Plan of Georgia, Inc. (Kaiser Permanente Conyers)
- Kaiser Permanente
- Kaiwell-Being, LLC
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.