Athens Community Council on Aging, Inc.

Primary specialty

Respite CareTaxonomy code 385H00000X

Legal business name

ATHENS COMMUNITY COUNCIL ON AGING, INC.

Practice address

1774 Old West Broad St
Athens, GA 30606-2865

Phone

(706) 548-6476

Fax

(706) 548-6133

NPI assigned

Jan 4, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Jennie Deese

Title

Ceo/President

Phone

(706) 549-4850

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397433600000",
    "number": "1174670947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 HOYT ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306012646",
            "telephone_number": "706-549-4850",
            "fax_number": "706-549-7786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1774 OLD WEST BROAD ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062865",
            "telephone_number": "706-548-6476",
            "fax_number": "706-548-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHENS COMMUNITY COUNCIL ON AGING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2014-04-14",
        "status": "A",
        "authorized_official_last_name": "DEESE",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "706-549-4850",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000120128A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Athens, GA
• Respite Care in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2014; 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.