Great Start Development Center, LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

GREAT START DEVELOPMENT CENTER, LLC

Practice address

975 Cobb Place Blvd NW Ste 101
Kennesaw, GA 30144-6848

Phone

(770) 713-6486

NPI assigned

Oct 30, 2018

Organization subpart

No

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

Authorized official

Name

Samantha Gray Miller

Title

Owner/Administrator

Phone

(770) 713-6486

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540857600000",
    "number": "1356818017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 COBB PLACE BLVD NW STE 101",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 COBB PLACE BLVD NW STE 101",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446848",
            "telephone_number": "770-713-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT START DEVELOPMENT CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-30",
        "last_updated": "2018-10-30",
        "status": "A",
        "authorized_official_last_name": "GRAY MILLER",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "770-713-6486"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER FOR BABIES CAN'T WAIT",
            "identifier": "252Y00000X",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erica Michelle Grant, LCSW
• Xavier Granville
• Mary Elizabeth Graves, PNP
• Michael Gray
• Zachary Paul Graziosi, RBT
• Angel Green
• Ashley Green
• Stephen Kelly Green, D.C.
• Emily Greenlaw
• Neaveh Gregory

• Early Intervention Provider Agency in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Early Intervention Provider Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.