NPIMap

Organization Active NPI

Monticello Personal Care Home

  • Custodial Care Facility
  • Monticello, GA
National Provider Identifier
1326577255
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
License
PCH009112 Issued in GA
Legal business name
MONTICELLO PERSONAL CARE HOME
Practice address
825 Eatonton St
Monticello, GA 31064-1029
Phone
(706) 875-7944
NPI assigned
Jun 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Anna Cotton
Title
Corporate Administrative Assistant
Phone
(770) 692-3875

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Custodial Care Facility 311Z00000X PCH009112 GA Primary

Addresses

Primary practice location

825 Eatonton St
Monticello, GA 31064-1029

Mailing address

825 Eatonton St
Monticello, GA 31064-1029
Phone (706) 875-7944

National Provider Directory

National Provider Directory
Tax ID family
Cartersville Personal Care Home3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1326577255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 EATONTON ST",
            "city": "MONTICELLO",
            "state": "GA",
            "postal_code": "310641029",
            "telephone_number": "706-875-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 EATONTON ST",
            "city": "MONTICELLO",
            "state": "GA",
            "postal_code": "310641029",
            "telephone_number": "706-875-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "COTTON",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "CORPORATE ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "770-692-3875"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "GA",
            "license": "PCH009112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.