Developmental Enrichment Services, Inc.

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

License

00016 Issued in GA

Legal business name

DEVELOPMENTAL ENRICHMENT SERVICES, INC.

Practice address

3615 S Rockbridge Rd
Stone Mountain, GA 30087-4408

Phone

(770) 879-0817

NPI assigned

Mar 30, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Gretchen V Jaccino, OTR

Title

President

Phone

(770) 879-0817

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gretchen A Vandewater, OTR/L

  • Occupational Therapist
  • Stone Mountain, GA
  • NPI 1609996750
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225158371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3615 S ROCKBRIDGE RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300874408",
            "telephone_number": "770-879-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3615 S ROCKBRIDGE RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300874408",
            "telephone_number": "770-879-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL ENRICHMENT SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACCINO",
        "authorized_official_first_name": "GRETCHEN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-879-0817",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "GA",
            "license": "00016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00599035",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rohit Manubhai Desai, MD
• Tejal Haresh Desai, AA
• Madison Rachelle Desch
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• Consuela Dickerson-Whitfield
• Kay Dickey, CPC

• Developmental Disabilities Clinic/Center in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Developmental Disabilities Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.