Malibu Health Care Agency, Inc,

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

107-R-0357 Issued in GA

Legal business name

MALIBU HEALTH CARE AGENCY, INC,

Practice address

24 Highway 213
Covington, GA 30014-7460

Phone

(770) 873-6303

NPI assigned

May 5, 2009

Organization subpart

No

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

Authorized official

Name

Marie Marthe Pierre

Title

Administrator/RN

Phone

(770) 873-6303

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241481600000",
    "number": "1376777482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 HIGHWAY 213",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300147460",
            "telephone_number": "770-873-6303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 HIGHWAY 213",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300147460",
            "telephone_number": "770-873-6303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MALIBU HEALTH CARE AGENCY, INC,",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2009-05-05",
        "status": "A",
        "authorized_official_last_name": "PIERRE",
        "authorized_official_first_name": "MARIE",
        "authorized_official_middle_name": "MARTHE",
        "authorized_official_title_or_position": "ADMINISTRATOR/RN",
        "authorized_official_telephone_number": "770-873-6303"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": "107-R-0357",
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "GA",
            "license": "107-R-0357",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF HUMAN RESOURCES",
            "identifier": "107-R-0357",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nursing Care Agency in Covington, GA
• Providers in Covington, GA by specialty
• Nursing Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; 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.