NPIMap

Organization Active NPI

Chris 180, Inc.

  • Community/Behavioral Health Agency
  • Atlanta, GA
National Provider Identifier
1205397247
Registry record updated Mar 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
CHRIS 180, INC.
Doing business as
@Promise Center
Practice address
740 Cameron M Alexander Blvd NW
Atlanta, GA 30318-6812
Phone
(404) 486-9034
Fax
(404) 835-9350
NPI assigned
Mar 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2019

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

Authorized official

Name
Dan James Bellor
Title
Clinic Administrator
Phone
(404) 486-9034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

740 Cameron M Alexander Blvd NW
Atlanta, GA 30318-6812

Mailing address

1017 Fayetteville Rd SE
Atlanta, GA 30316-2932
Phone (404) 486-9034

Other identifiers 2

IdentifierTypeStateIssuer
640804505IMedicaidGA
300023628AMedicaidGA

Other names 1

  • @Promise Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Chris 180 Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

740 Cameron M Alexander Blvd NW
Atlanta, GA 30318
Phone (813) 362-0340

NPI Registry JSON

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

{
    "created_epoch": "1553904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553904000000",
    "number": "1205397247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 FAYETTEVILLE RD SE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303162932",
            "telephone_number": "404-486-9034",
            "fax_number": "404-835-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 CAMERON M ALEXANDER BLVD NW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303186812",
            "telephone_number": "404-486-9034",
            "fax_number": "404-835-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRIS 180, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-30",
        "last_updated": "2019-03-30",
        "status": "A",
        "authorized_official_last_name": "BELLOR",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "404-486-9034"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "640804505I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300023628A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "@Promise Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2019; 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.