Organization Active NPI

Engaged Living Seniors

  • Home Health Agency
  • Atlanta, GA
National Provider Identifier
1215779038
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
ENGAGED LIVING SENIORS
Practice address
3550 Lenox Rd NE Ste 2100
Atlanta, GA 30326-1810
Phone
(404) 480-3341
NPI assigned
Jun 11, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Authorized official

Name
Raphael Fleuristal
Title
Owner
Phone
(239) 699-3264

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary
In Home Supportive Care Agency 253Z00000X

Addresses

Primary practice location

3550 Lenox Rd NE Ste 2100
Atlanta, GA 30326-1810

Mailing address

3550 Lenox Rd NE Ste 2100
Atlanta, GA 30326-1810

National Provider Directory

National Provider Directory

Locations

3550 Lenox Rd NE
Ste 2100
Atlanta, GA 30326
Phone (404) 480-3341

NPI Registry JSON

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718582400000",
    "number": "1215779038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3550 LENOX RD NE STE 2100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3550 LENOX RD NE STE 2100",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303261810",
            "telephone_number": "404-480-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENGAGED LIVING SENIORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A",
        "authorized_official_last_name": "FLEURISTAL",
        "authorized_official_first_name": "RAPHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-699-3264"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 17, 2024; 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.