Little Debbie'S Second Chance Home, Inc.

Primary specialty

Emotionally Disturbed Childrens' Residential Treatment FacilityTaxonomy code 322D00000X

License

CC1001625 Issued in GA

Legal business name

LITTLE DEBBIE'S SECOND CHANCE HOME, INC.

Practice address

3900 Leprechaun CT
Decatur, GA 30034-2168

Phone

(770) 912-3742

Fax

(404) 288-0671

NPI assigned

Feb 2, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Lakisha Shavon Stiggers

Title

Executive Director

Phone

(770) 912-3742

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1487792396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 LEPRECHAUN CT",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300342168",
            "telephone_number": "770-912-3742",
            "fax_number": "404-288-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 LEPRECHAUN CT",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300342168",
            "telephone_number": "770-912-3742",
            "fax_number": "404-288-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE DEBBIE'S SECOND CHANCE HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "STIGGERS",
        "authorized_official_first_name": "LAKISHA",
        "authorized_official_middle_name": "SHAVON",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "770-912-3742",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "322D00000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
            "state": "GA",
            "license": "CC1001625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "585299164A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Emotionally Disturbed Childrens' Residential Treatment Facility in Decatur, GA
• Providers in Decatur, GA by specialty
• Emotionally Disturbed Childrens' Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.