Silvercrest Personal Care Home, Inc

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

SILVERCREST PERSONAL CARE HOME, INC

Practice address

6720 Princeton Park Walk
Lithonia, GA 30058-7031

Phone

(770) 484-3034

NPI assigned

Sep 4, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Rosetta Johnson

Title

Owner

Phone

(770) 484-3034

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188864000000",
    "number": "1154515906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6720 PRINCETON PARK WALK",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587031",
            "telephone_number": "770-484-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6720 PRINCETON PARK WALK",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587031",
            "telephone_number": "770-484-3034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVERCREST PERSONAL CARE HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ROSETTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-484-3034",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Lithonia, GA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.