Chestnut Manor, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

12040 Issued in GA

Legal business name

CHESTNUT MANOR, INC.

Practice address

8673 Chestnut LN
Lithia Springs, GA 30122-3410

Phone

(770) 920-9369

NPI assigned

Nov 4, 2011

Last updated

Nov 4, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shirley Napier-Brady

Title

Executive Director

Phone

(770) 920-9369

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1320364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320364800000",
    "number": "1386921336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8673 CHESTNUT LN",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301223410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8673 CHESTNUT LN",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301223410",
            "telephone_number": "770-920-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTNUT MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-04",
        "last_updated": "2011-11-04",
        "status": "A",
        "authorized_official_last_name": "NAPIER-BRADY",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "770-920-9369",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "GA",
            "license": "12040",
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "GA",
            "license": "12040",
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "GA",
            "license": "12040",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Lithia Springs, GA
• Providers in Lithia Springs, GA by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2011; 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.