Agathos Place, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

AGATHOS PLACE, INC.

Practice address

4595 Jonesboro Rd
Forest Park, GA 30297-4317

Phone

(470) 755-6710

Fax

(470) 755-6710

NPI assigned

Oct 30, 2017

Last updated

Oct 30, 2017By 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

Mrs. Tiffany Denise GilesNPI 1629580600

Title

Ceo

Phone

(470) 755-6710

Specialties & licenses 1

Addresses

Locations

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.

• Tiffany Denise Giles

  • Community/Behavioral Health Agency
  • Forest Park, GA
  • NPI 1629580600
  NPD (past) Authorized official

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

{
    "created_epoch": "1509321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509321600000",
    "number": "1326550401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2714 WATERFORD CLUB DR",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301224413",
            "telephone_number": "470-755-6710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4595 JONESBORO RD",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302974317",
            "telephone_number": "470-755-6710",
            "fax_number": "470-755-6710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGATHOS PLACE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-30",
        "last_updated": "2017-10-30",
        "status": "A",
        "authorized_official_last_name": "GILES",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "470-755-6710",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Forest Park, GA
• Providers in Forest Park, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2017; 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.