Bryana Personal Care Home, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

044-01-357-2 Issued in GA

Legal business name

BRYANA PERSONAL CARE HOME, INC.

Practice address

6276 Field Glen Rd
Stone Mountain, GA 30087-4911

Phone

(678) 587-5543

Fax

(678) 587-5543

NPI assigned

Aug 9, 2013

Organization subpart

No

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

Authorized official

Name

Diane Charles

Title

Ceo

Phone

(404) 454-7155

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Bryana Personal Care Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bryana Personal Care Home

  • Intellectual Disabilities Intermediate Care Facility
  • Stone Mountain, GA
  • NPI 1275863383
  NPD tax ID

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376006400000",
    "number": "1457783789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6276 FIELD GLEN RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300874911",
            "telephone_number": "678-587-5543",
            "fax_number": "678-587-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6276 FIELD GLEN RD",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300874911",
            "telephone_number": "678-587-5543",
            "fax_number": "678-587-5543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYANA PERSONAL CARE HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-09",
        "last_updated": "2013-08-09",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "DIANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-454-7155"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "044-01-357-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "921820039A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "921820039D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosenita Brown
• Shannon Brown
• Zauria Brown
• Melissa Brunson, LPC
• Bryana Personal Care Home
• Ashley Nicole Bryant, CPNP-PC
• Teleshcia Bryant
• Takela L Bugg, MEDICAL ASSISTANT
• Vy Bui
• Building a Solid Foundation

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.