Masalon Personal Care Home Inc.

Primary specialty

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

Legal business name

MASALON PERSONAL CARE HOME INC.

Practice address

3952 Rockbridge Rd
Stone Mountain, GA 30083-4170

Phone

(917) 826-4317

NPI assigned

May 13, 2020

Organization subpart

No

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

Authorized official

Name

Makesa Mamie Fofana

Title

Owner

Phone

(917) 826-4317

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1589328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589328000000",
    "number": "1306468228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3952 ROCKBRIDGE RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300834170",
            "telephone_number": "917-826-4317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3952 ROCKBRIDGE RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300834170",
            "telephone_number": "917-826-4317"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASALON PERSONAL CARE HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-13",
        "last_updated": "2020-05-13",
        "certification_date": "2020-05-13",
        "status": "A",
        "authorized_official_last_name": "FOFANA",
        "authorized_official_first_name": "MAKESA",
        "authorized_official_middle_name": "MAMIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-826-4317"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margie'S Natural Care & Adult Services
• Honidu Marico, CHW CPS-P DOULA CMC
• Tyonna Regdrica Marshall
• Margaret Lamar Martin, LCSW
• Maria Martinez-Barnes, NP
• Lauren Elizabeth Mason, RN, PNP
• Sherri Mason, MASSAGE THERAPIST
• Walter Monroe Massey III, RPH
• Frenny K Mathew
• Joseph D Matthews Jr.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Stone Mountain, GA
• Providers in Stone Mountain, 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 May 13, 2020; 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.