Bryana Personal Care Home

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

BRYANA PERSONAL CARE HOME

Practice address

6276 Field Glen Rd
Stone Mountain, GA 30087-4911

Phone

(404) 454-7155

NPI assigned

Jan 12, 2010

Last updated

Jan 12, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Diane Charles

Title

Ceo

Phone

(404) 454-7155

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Bryana Personal Care Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Bryana Personal Care Home, Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Stone Mountain, GA
  • NPI 1457783789
  NPD tax ID

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

{
    "created_epoch": "1263254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1275863383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6276 FIELD GLEN RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300874911",
            "telephone_number": "404-454-7155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6276 FIELD GLEN RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300874911",
            "telephone_number": "404-454-7155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYANA PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-12",
        "last_updated": "2010-01-12",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-454-7155"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PROVIDER NUMBER",
            "identifier": "921820039A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rashida W Brown, PHD
• Rosenita Brown
• Shannon Brown
• Zauria Brown
• Melissa Brunson, LPC
• Bryana Personal Care Home, Inc.
• Ashley Nicole Bryant, CPNP-PC
• Teleshcia Bryant
• Takela L Bugg, MEDICAL ASSISTANT
• Vy Bui

• Intellectual Disabilities Intermediate Care Facility in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Intellectual Disabilities Intermediate Care Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; 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.