Community Care Home Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

060013141 Issued in GA

Legal business name

COMMUNITY CARE HOME INC.

Practice address

659 Wilmont Dr
Jonesboro, GA 30238-4834

Phone

(404) 375-3655

Fax

(404) 209-8131

NPI assigned

Nov 16, 2010

Organization subpart

No

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

Authorized official

Name

Cathy Burke

Title

Owner

Phone

(404) 375-3644

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1134420516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2045 MOUNT ZION RD # 373",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302603313",
            "telephone_number": "404-375-3655",
            "fax_number": "404-209-8131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 WILMONT DR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302384834",
            "telephone_number": "404-375-3655",
            "fax_number": "404-209-8131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-375-3644"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "060013141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.