Positive Impact Residential Services

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

CSW002378 Issued in GA

Legal business name

POSITIVE IMPACT RESIDENTIAL SERVICES

Practice address

2189 W Ponce de Leon Ave
Decatur, GA 30030-2334

Phone

(678) 887-3263

Fax

(404) 687-9871

NPI assigned

Feb 25, 2014

Organization subpart

No

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

Authorized official

Name

Wax Flowers

Title

LCSW/Owner

Phone

(866) 730-7604

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1393286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393286400000",
    "number": "1487079562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2189 W PONCE DE LEON AVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302334",
            "telephone_number": "678-887-3263",
            "fax_number": "404-687-9871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2189 W PONCE DE LEON AVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302334",
            "telephone_number": "678-887-3263",
            "fax_number": "404-687-9871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POSITIVE IMPACT RESIDENTIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-25",
        "last_updated": "2014-02-25",
        "status": "A",
        "authorized_official_last_name": "FLOWERS",
        "authorized_official_first_name": "WAX",
        "authorized_official_title_or_position": "LCSW/OWNER",
        "authorized_official_telephone_number": "866-730-7604"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "GA",
            "license": "CSW002378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Bradley Porter, MS RD LD
• Tameca Porter
• Kimberly Dionne Posey, MD
• Positive Directions Counseling & Behavioral Health Services, Inc.
• Positive Impact Health Centers, Inc.
• Hannah Rose Posluszny, RDN
• Post Surgery Care of Atlanta, LLC
• Megan Osborne Post, DDS
• Sudheer Potru, D.O.
• Potters Touch Counseling Inc.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Decatur, GA
• Providers in Decatur, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2014; 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.