Aiden's Place, LLC

Primary specialty

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

License

PCH008079 Issued in GA

Legal business name

AIDEN'S PLACE, LLC

Practice address

7370 Wright Dr
Atlanta, GA 30349-7911

Phone

(770) 573-1076

Fax

(770) 234-5894

NPI assigned

Oct 3, 2011

Last updated

Oct 3, 2011By 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

Rondine D Gordon

Title

Ceo

Phone

(770) 573-1076

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1316221815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 ROCKBRIDGE RD",
            "address_2": "SUITE 208-196",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873064",
            "telephone_number": "770-573-1076",
            "fax_number": "770-234-5894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7370 WRIGHT DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303497911",
            "telephone_number": "770-573-1076",
            "fax_number": "770-234-5894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIDEN'S PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-03",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "RONDINE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-573-1076"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "GA",
            "license": "PCH008079",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "PCH008079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Atlanta, GA
• Providers in Atlanta, 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 Oct 3, 2011; 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.