NPIMap

Organization Active NPI

Paradise Grove Adult Care Center Inc

  • Adult Care Home Facility
  • Hampton, GA
National Provider Identifier
1235562786
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
13-00030126 Issued in GA
Legal business name
PARADISE GROVE ADULT CARE CENTER INC
Practice address
10854 Paladin Dr
Hampton, GA 30228-3340
Phone
(770) 882-8401
NPI assigned
Aug 19, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Authorized official

Name
Michelle GayNPI 1235395039
Title
Ceo
Phone
(770) 882-8401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 13-00030126 GA Primary

Addresses

Primary practice location

10854 Paladin Dr
Hampton, GA 30228-3340

Mailing address

10854 Paladin Dr
Hampton, GA 30228-3340
Phone (770) 882-8401

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1376870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376870400000",
    "number": "1235562786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10854 PALADIN DR",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302283340",
            "telephone_number": "770-882-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10854 PALADIN DR",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302283340",
            "telephone_number": "770-882-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARADISE GROVE ADULT CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-19",
        "last_updated": "2013-08-19",
        "status": "A",
        "authorized_official_last_name": "GAY",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-882-8401"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "GA",
            "license": "13-00030126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.