Organization Active NPI

Amazing Grace Christian Senior Services

  • Assisted Living Facility
  • Hampton, GA
National Provider Identifier
1316704547
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
AMAZING GRACE CHRISTIAN SENIOR SERVICES
Doing business as
Amazing Grace Christian Senior Services
Practice address
17 W Main St
Hampton, GA 30228-2190
Phone
(770) 912-4796
NPI assigned
Mar 4, 2024
Last updated
Mar 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Mrs. Farrah JngillesNPI 1023637881
Title
Ceo
Phone
(678) 562-0026

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

17 W Main St
Hampton, GA 30228-2190

Mailing address

133 Ethan Moor
Jonesboro, GA 30238-5893
Phone (770) 912-4796

Other names 1

  • AMAZING GRACE CHRISTIAN SENIOR SERVICES Doing business as

National Provider Directory

National Provider Directory

Locations

17 W Main St
Hampton, GA 30228
Phone (770) 912-4796

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1316704547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 ETHAN MOOR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302385893",
            "telephone_number": "770-912-4796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W MAIN ST",
            "city": "HAMPTON",
            "state": "GA",
            "postal_code": "302282190",
            "telephone_number": "770-912-4796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING GRACE CHRISTIAN SENIOR SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "JNGILLES",
        "authorized_official_first_name": "FARRAH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-562-0026",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMAZING GRACE CHRISTIAN SENIOR SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hampton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.