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Georgia Mountain Commmunity Services

Organization Active NPI Developmentally Disabled Services Day Training Agency · Gainesville, GA

NPI 1194046433 · NPPES record last updated Jun 22, 2010

Key facts

NPI
1194046433
Entity type
Organization (NPI type 2)
Primary specialty
Developmentally Disabled Services Day Training Agency 251C00000X
Legal business name
GEORGIA MOUNTAIN COMMMUNITY SERVICES
Practice address
2912 Evergreen Hollow Dr
Gainesville, GA 30507-9607
Phone
(770) 297-9541
NPI assigned
Jun 22, 2010
Organization subpart
No

Authorized official

Name
Loretta Jones
Title
Business Analyst
Phone
(678) 513-5762

Corporate family (same tax ID) 24

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

National Provider Directory

Tax ID family
Georgia Mountain Community SVS (127 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Yes

Addresses

Primary practice location

2912 Evergreen Hollow Dr
Gainesville, GA 30507-9607

Mailing address

4331 Thurmon Tanner Rd
Flowery Branch, GA 30542-2829
Phone (678) 513-5762

Other identifiers

IdentifierTypeStateIssuer
000607054BRMedicaidGA

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 22, 2010.

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1194046433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4331 THURMON TANNER RD",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305422829",
            "telephone_number": "678-513-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 EVERGREEN HOLLOW DR",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305079607",
            "telephone_number": "770-297-9541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA MOUNTAIN COMMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-22",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "LORETTA",
        "authorized_official_title_or_position": "BUSINESS ANALYST",
        "authorized_official_telephone_number": "678-513-5762"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000607054BR",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

All providers in Gainesville, GA · Developmentally Disabled Services Day Training Agency in Georgia

Sources for this page

Verify at the official NPI Registry.