Sovereign House of Respite, LLC

Primary specialty

Respite CareTaxonomy code 385H00000X

Legal business name

SOVEREIGN HOUSE OF RESPITE, LLC

Doing business as

Sovereign House Agency, LLC

Practice address

5977 Whitesville Rd
Unit 14
Columbus, GA 31904-3660

Phone

(706) 221-6281

Fax

(706) 221-6289

NPI assigned

Sep 27, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Vicky / Gloria Jolly / Lewis

Title

Owners/Administrators

Phone

(706) 304-4325

Specialties & licenses 1

Addresses

Other names 1

• Sovereign House Agency, LLC Doing business as

Locations

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354147200000",
    "number": "1346559226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5977 WHITESVILLE RD",
            "address_2": "UNIT 14",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319043660",
            "telephone_number": "706-221-6281",
            "fax_number": "706-221-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5977 WHITESVILLE RD",
            "address_2": "UNIT 14",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319043660",
            "telephone_number": "706-221-6281",
            "fax_number": "706-221-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN HOUSE OF RESPITE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-27",
        "last_updated": "2012-11-29",
        "status": "A",
        "authorized_official_last_name": "JOLLY / LEWIS",
        "authorized_official_first_name": "VICKY / GLORIA",
        "authorized_official_title_or_position": "OWNERS/ADMINISTRATORS",
        "authorized_official_telephone_number": "706-304-4325",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sovereign House Agency, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Respite Care in Columbus, GA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2012; 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.