NPIMap

Organization Active NPI

Briarlake Community Home

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Decatur, GA
National Provider Identifier
1154486496
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
License
044232 Issued in GA
Legal business name
BRIARLAKE COMMUNITY HOME
Practice address
1714 Briarlake Cir
Decatur, GA 30033-1110
Phone
(404) 633-5251
Fax
(404) 728-1518
NPI assigned
Dec 27, 2006
Last updated
Aug 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

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

Authorized official

Name
Tashua Grizzle
Title
Administrator
Phone
(404) 212-4676

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X 044232 GA Primary

Addresses

Primary practice location

1714 Briarlake Cir
Decatur, GA 30033-1110

Mailing address

1714 Briarlake Cir
Decatur, GA 30033-1110
Phone (404) 633-5251

Other identifiers 1

IdentifierTypeStateIssuer
000954324JMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
East Central Reg Hospital53 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 20

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1154486496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 BRIARLAKE CIR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331110",
            "telephone_number": "404-633-5251",
            "fax_number": "404-728-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 BRIARLAKE CIR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300331110",
            "telephone_number": "404-633-5251",
            "fax_number": "404-728-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIARLAKE COMMUNITY HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "GRIZZLE",
        "authorized_official_first_name": "TASHUA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "404-212-4676"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "044232",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000954324J",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; 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.