Keb Inc

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

License

00882626A Issued in GA

Legal business name

KEB INC

Doing business as

HAVENS HOME

Practice address

8320 Cedar Grove Rd
Fairburn, GA 30213-2337

Phone

(770) 964-3173

NPI assigned

Jan 7, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth Edward Bailey

Title

Ceo

Phone

(770) 964-3173

Specialties & licenses 1

Addresses

Other names 1

• HAVENS HOME Doing business as

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

{
    "created_epoch": "1168128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417005612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8320 CEDAR GROVE RD",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302132337",
            "telephone_number": "770-964-3173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8320 CEDAR GROVE RD",
            "city": "FAIRBURN",
            "state": "GA",
            "postal_code": "302132337",
            "telephone_number": "770-964-3173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-964-3173",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "GA",
            "license": "00882626A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HAVENS HOME",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Developmental Disabilities Clinic/Center in Fairburn, GA
• Providers in Fairburn, GA by specialty
• Developmental Disabilities Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.