Liagiba, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

LIAGIBA, INC

Doing business as

Abigail Manor Personal Care Home

Practice address

518 Lake Michele CT
Stone Mountain, GA 30088-1401

Phone

(770) 365-6820

Fax

(678) 528-3017

NPI assigned

Feb 13, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Evan Williams, PHD

Title

Ceo/Owner

Phone

(770) 365-6820

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Abigail Manor Personal Care Home Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581552000000",
    "number": "1366075848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "518 LAKE MICHELE CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300881401",
            "fax_number": "678-528-3017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "518 LAKE MICHELE CT",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300881401",
            "telephone_number": "770-365-6820",
            "fax_number": "678-528-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIAGIBA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "770-365-6820",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "845251295B",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "abigailmanor@comcast.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Facimile",
            "address_1": "518 Lake Michele Ct",
            "city": "Stone Mountain",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300881401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Abigail Manor Personal Care Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.