NPIMap

Organization Active NPI

Heavenly Arms Assisted Living Personal Care Home

  • Assisted Living Facility (Mental Illness)
  • Covington, GA
National Provider Identifier
1134467251
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
BLP-18639 Issued in GA
Legal business name
HEAVENLY ARMS ASSISTED LIVING PERSONAL CARE HOME
Practice address
11230 Highway 278 E
Covington, GA 30014-1673
Phone
(678) 625-4216
Fax
(678) 625-7793
NPI assigned
Jan 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Authorized official

Name
Vida A L Thompson
Title
Owner
Phone
(678) 625-4216

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X BLP-18639 GA Primary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X BLP-18639 GA

Addresses

Primary practice location

11230 Highway 278 E
Covington, GA 30014-1673

Mailing address

11230 Highway 278 E
Covington, GA 30014-1673
Phone (678) 625-4216

National Provider Directory

National Provider Directory
Tax ID family
Heavenly Arms Assisted Living Personal Care Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1358985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358985600000",
    "number": "1134467251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11230 HIGHWAY 278 E",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300141673",
            "telephone_number": "678-625-4216",
            "fax_number": "678-625-7793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11230 HIGHWAY 278 E",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300141673",
            "telephone_number": "678-625-4216",
            "fax_number": "678-625-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY ARMS ASSISTED LIVING PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-24",
        "last_updated": "2013-01-24",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "VIDA",
        "authorized_official_middle_name": "A L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-625-4216"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "GA",
            "license": "BLP-18639",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "BLP-18639",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.