Active NPI
Quality Care Adult Day Habilitation
- Developmentally Disabled Services Day Training Agency
- Fayetteville, GA
National Provider Identifier
1194988568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- Legal business name
- QUALITY CARE ADULT DAY HABILITATION
- Practice address
- 135A Walker Pkwy
Fayetteville, GA 30214-1485 - Phone
- (770) 716-3627
- Fax
- (770) 716-3672
- NPI assigned
- Jul 7, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Pamela Barnes
- Title
- Ceo
- Phone
- (770) 716-3627
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmentally Disabled Services Day Training Agency | 251C00000X | Primary |
Addresses
Primary practice location
135A Walker Pkwy
Fayetteville, GA 30214-1485
Mailing address
135A Walker Pkwy
Fayetteville, GA 30214-1485
Phone (770) 716-3627
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 604705391A | Medicaid | GA |
National Provider Directory
National Provider Directory- Tax ID family
- Quality Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Developmentally Disabled Services Day Training Agency
- Fayetteville, GA
- NPI 1164577417
Locations
135A Walker Pkwy
Fayetteville, GA 30214
Phone (770) 716-3627
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215388800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1215388800000",
"number": "1194988568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "135A WALKER PKWY",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302141485",
"telephone_number": "770-716-3627",
"fax_number": "770-716-3672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135A WALKER PKWY",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302141485",
"telephone_number": "770-716-3627",
"fax_number": "770-716-3672"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "QUALITY CARE ADULT DAY HABILITATION",
"organizational_subpart": "NO",
"enumeration_date": "2008-07-07",
"last_updated": "2008-07-07",
"status": "A",
"authorized_official_last_name": "BARNES",
"authorized_official_first_name": "PAMELA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "770-716-3627",
"authorized_official_name_prefix": "Mrs."
},
"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": "604705391A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Fayetteville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.