Green Parkpch,Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

033-01-183-1 Issued in GA

Legal business name

GREEN PARKPCH,INC

Practice address

2941 Sandy Plains Rd
Marietta, GA 30066-4652

Phone

(770) 596-4511

NPI assigned

Aug 19, 2011

Organization subpart

No

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

Authorized official

Name

Mrs. Kate Emefiele

Title

Administrator

Phone

(770) 596-4511

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313712000000",
    "number": "1437439676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2941 SANDY PLAINS RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664652",
            "telephone_number": "770-596-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2941 SANDY PLAINS RD",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664652",
            "telephone_number": "770-596-4511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN PARKPCH,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-19",
        "last_updated": "2011-08-19",
        "status": "A",
        "authorized_official_last_name": "EMEFIELE",
        "authorized_official_first_name": "KATE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-596-4511",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "033-01-183-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003104775A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "549666152A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Marietta, GA
• Providers in Marietta, 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 Aug 19, 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.