Active NPI
Kairova Wellness Center LLC
- Community/Behavioral Health Agency
- Jonesboro, GA
National Provider Identifier
1285578864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- KAIROVA WELLNESS CENTER LLC
- Practice address
- 650 Mount Zion Rd Ste a
Jonesboro, GA 30236-1560 - Phone
- (470) 202-0415
- NPI assigned
- Apr 15, 2026
- Last updated
- Aug 20, 2026
- 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
- Shanequa Pierce
- Title
- Owner
- Phone
- (470) 202-0438
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Mental Health Counselor | 101YM0800X | |||
| Clinical Child & Adolescent Psychologist | 103TC2200X | |||
| Group Psychotherapy Psychologist | 103TP2701X | |||
| Meals Provider | 174200000X | |||
| Case Management Agency | 251B00000X | |||
| Developmentally Disabled Services Day Training Agency | 251C00000X | |||
| Community/Behavioral Health Agency | 251S00000X | Primary | ||
| Foster Care Agency | 253J00000X | |||
| In Home Supportive Care Agency | 253Z00000X | |||
| Clinic/Center | 261Q00000X | |||
| Community Health Clinic/Center | 261QC1500X | |||
| Prison Health Clinic/Center | 261QP2400X | |||
| Rehabilitation Clinic/Center | 261QR0400X | |||
| Non-emergency Medical Transport (VAN) | 343900000X |
Addresses
Primary practice location
650 Mount Zion Rd Ste a
Jonesboro, GA 30236-1560
Mailing address
650 Mount Zion Rd Ste a
Jonesboro, GA 30236-1560
Other practice location 1
4030 Wake Forest Rd
Suite 349
Raleigh, North Carolina 27609
UM
National Provider Directory
National Provider DirectoryLocations
650 Mount Zion Rd
Ste A
Jonesboro, GA 30236
Phone (470) 202-0415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776211200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1787184000000",
"number": "1285578864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 MOUNT ZION RD STE A",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302361560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 MOUNT ZION RD STE A",
"city": "JONESBORO",
"state": "GA",
"postal_code": "302361560",
"telephone_number": "470-202-0415"
}
],
"practiceLocations": [
{
"address_1": "4030 Wake Forest Rd",
"address_2": "Suite 349",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "North Carolina",
"postal_code": "27609",
"country_code": "UM",
"country_name": "United States Minor Outlying Islands",
"address_type": "FGN"
}
],
"basic": {
"organization_name": "KAIROVA WELLNESS CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-04-15",
"last_updated": "2026-08-20",
"certification_date": "2026-08-20",
"status": "A",
"authorized_official_last_name": "PIERCE",
"authorized_official_first_name": "SHANEQUA",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "470-202-0438"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TC2200X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": null,
"license": null,
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Group Psychotherapy",
"state": null,
"license": null,
"primary": false
},
{
"code": "174200000X",
"taxonomy_group": "",
"desc": "Meals",
"state": null,
"license": null,
"primary": false
},
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "251C00000X",
"taxonomy_group": "",
"desc": "Day Training, Developmentally Disabled Services",
"state": null,
"license": null,
"primary": false
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "253J00000X",
"taxonomy_group": "",
"desc": "Foster Care Agency",
"state": null,
"license": null,
"primary": false
},
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "261Q00000X",
"taxonomy_group": "",
"desc": "Clinic/Center",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP2400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Prison Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QR0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Rehabilitation",
"state": null,
"license": null,
"primary": false
},
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.