Signature Care of Georgia LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

CLA002022 Issued in GA

Legal business name

SIGNATURE CARE OF GEORGIA LLC

Practice address

172 Herring St
Athens, GA 30601-3148

Phone

(706) 224-4531

NPI assigned

Mar 3, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Michael Pope

Title

Coo

Phone

(678) 485-2527

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Signature Care of Georgia LLC2 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.

• Signature Activity Center

  • Developmentally Disabled Services Day Training Agency
  • Athens, GA
  • NPI 1730694639
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Signature Activity Center

  • Developmentally Disabled Services Day Training Agency
  • Athens, GA
  • NPI 1730694639
  NPPES parent name

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

{
    "created_epoch": "1267574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459382400000",
    "number": "1295058378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 80044",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306080044",
            "telephone_number": "706-224-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 HERRING ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306013148",
            "telephone_number": "706-224-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE CARE OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-03",
        "last_updated": "2016-03-31",
        "status": "A",
        "authorized_official_last_name": "POPE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "678-485-2527",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "CLA002022",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "222938820E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rubina Sial, M.D.
• Omar Ahmed Siddiqui, PHARMD
• Julie Beth Siegel, MD
• Brittany Sigg
• Signature Activity Center
• Allia Siler, LCSW
• Silverleaf Hospice, Inc.
• Ashley Nicole Simmons
• Barron David Simmons, DDS
• Jasmine Simmons, LAPC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Athens, GA
• Providers in Athens, GA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2016; 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.