Active NPI
Georgia Health Services Network, LLC
- Assisted Living Facility
- Monroe, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- GEORGIA HEALTH SERVICES NETWORK, LLC
- Practice address
- 155 Bankers Blvd
BLDG a, Suite 100
Monroe, GA 30655-7722 - Phone
- (770) 466-7771
- NPI assigned
- Oct 16, 2012
- Last updated
- Oct 16, 2012
- 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. Carolyn Fagan, R.N.
- Title
- Ceo
- Phone
- (770) 466-7771
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | GA | Primary |
Addresses
Primary practice location
155 Bankers Blvd
BLDG a, Suite 100
Monroe, GA 30655-7722
Mailing address
PO Box 2966
Loganville, GA 30052-1967
Phone (770) 466-7771
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 124697600A | Medicaid | GA |
National Provider Directory
National Provider Directory- Tax ID family
- Georgia Health Services Network LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Case Management Agency
- Loganville, GA
- NPI 1457413023
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Case Management Registered Nurse
- Watkinsville, GA
- NPI 1437015161
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1350345600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1350345600000",
"number": "1265785273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2966",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300521967",
"telephone_number": "770-466-7771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "155 BANKERS BLVD",
"address_2": "BLDG A, SUITE 100",
"city": "MONROE",
"state": "GA",
"postal_code": "306557722",
"telephone_number": "770-466-7771"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GEORGIA HEALTH SERVICES NETWORK, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-10-16",
"last_updated": "2012-10-16",
"status": "A",
"authorized_official_last_name": "FAGAN",
"authorized_official_first_name": "CAROLYN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "770-466-7771",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "R.N."
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "GA",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "124697600A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monroe, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.