Organization Active NPI

Phoenix Haven Africa Inc.

  • Personal Emergency Response Attendant
  • Buford, GA
National Provider Identifier
1184347049
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Personal Emergency Response AttendantTaxonomy code 146D00000X
Legal business name
PHOENIX HAVEN AFRICA INC.
Practice address
115 E Main St
Buford, GA 30518-5727
Phone
(470) 593-8438
NPI assigned
Sep 26, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Authorized official

Name
Mr. Tato Gayflorsee, ADMINISTRATOR, MPA
Title
Executive Director
Phone
(404) 437-9073

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101Y00000X
Pastoral CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP1600X
Personal Emergency Response AttendantGroup: 193200000X MULTI-SPECIALTY GROUP 146D00000X Primary
Case Manager/Care CoordinatorGroup: 193200000X MULTI-SPECIALTY GROUP 171M00000X
Meals Provider 174200000X
Case Management Agency 251B00000X
Public Health or Welfare Agency 251K00000X
Voluntary or Charitable Agency 251V00000X
Home Delivered Meals 332U00000X
Adult CompanionGroup: 193200000X MULTI-SPECIALTY GROUP 372600000X
Day Training/Habilitation SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 373H00000X

Addresses

Primary practice location

115 E Main St
Buford, GA 30518-5727

Mailing address

3808 Prospect Point Dr
Oakwood, GA 30566-0350
Phone (470) 872-7208

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664150400000",
    "number": "1184347049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 PROSPECT POINT DR",
            "city": "OAKWOOD",
            "state": "GA",
            "postal_code": "305660350",
            "telephone_number": "470-872-7208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E MAIN ST",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305185727",
            "telephone_number": "470-593-8438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HAVEN AFRICA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-24",
        "status": "A",
        "authorized_official_last_name": "GAYFLORSEE",
        "authorized_official_first_name": "TATO",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "404-437-9073",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ADMINISTRATOR, MPA"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "146D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Personal Emergency Response Attendant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "373H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; 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.