Fellowship Senior Day Care Center, Inc

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

000682459B Issued in GA

Legal business name

FELLOWSHIP SENIOR DAY CARE CENTER, INC

Practice address

4530 Janice Dr
College Park, GA 30337-5204

Phone

(404) 766-6498

Fax

(404) 766-6419

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Dominique Naar

Title

Director

Phone

(404) 766-6498

Specialties & licenses 3

Addresses

Other identifiers 4

Tax ID family

Fellowship Senior Day Care Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Fellowship Senior Day Care Center Inc

  • Alzheimer Center (Dementia Center)
  • College Park, GA
  • NPI 1013083278
  NPD tax ID

Locations

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664928000000",
    "number": "1336286350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 JANICE DR",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303375204",
            "telephone_number": "404-766-6498",
            "fax_number": "404-766-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 JANICE DR",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303375204",
            "telephone_number": "404-766-6498",
            "fax_number": "404-766-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FELLOWSHIP SENIOR DAY CARE CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A",
        "authorized_official_last_name": "NAAR",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "404-766-6498"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "GA",
            "license": "000682459B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000682459C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000682459D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013083278",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000682459B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Alzheimer Center (Dementia Center) in College Park, GA
• Providers in College Park, GA by specialty
• Alzheimer Center (Dementia Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.