Yilla Personal Care Home, Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

044-01-850-2 Issued in GA

Legal business name

YILLA PERSONAL CARE HOME, INC

Practice address

6226 Windy Ridge TRL
Lithonia, GA 30058-6625

Phone

(631) 848-3740

Fax

(770) 783-6604

NPI assigned

Sep 14, 2010

Organization subpart

No

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

Authorized official

Name

Racquel Yilla, RN

Title

Ceo

Phone

(631) 848-3740

Specialties & licenses 1

Addresses

Other identifiers 10

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338595200000",
    "number": "1467769398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6226 WINDY RIDGE TRL",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300586625",
            "telephone_number": "631-848-3740",
            "fax_number": "770-783-6604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6226 WINDY RIDGE TRL",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300586625",
            "telephone_number": "631-848-3740",
            "fax_number": "770-783-6604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YILLA PERSONAL CARE HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-14",
        "last_updated": "2012-06-02",
        "status": "A",
        "authorized_official_last_name": "YILLA",
        "authorized_official_first_name": "RACQUEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-848-3740",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "044-01-850-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "776635011F",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "776635011A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "776635011I",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "776635011G",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "776635011H",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "776635011D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "776635011C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "609202851A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "776635011E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "776635011B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ameta Lasha Wright
• Evonda Wyatt
• Sonji Wyche
• Christina Marie Yadao, M.D.
• Glendy Yeh, OD
• Marsha T. Youmans, MOT, OTR/L
• Colleen Young, RN
• Maxine Young
• Catherine M Youngblood, RN
• Za1603 LC

• Community/Behavioral Health Agency in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2012; 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.