NPIMap

Organization Active NPI

Azaria Personal Care Home LLC

  • Adult Care Home Facility
  • Lawrenceville, GA
National Provider Identifier
1508094855
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
067013581 Issued in GA
Legal business name
AZARIA PERSONAL CARE HOME LLC
Practice address
1753 Azalea Dr
Lawrenceville, GA 30043-3264
Phone
(770) 682-3753
NPI assigned
Jun 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Authorized official

Name
Mrs. Steluta Pertea, CNA
Title
Administrator
Phone
(770) 682-3753

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 067013581 GA Primary

Addresses

Primary practice location

1753 Azalea Dr
Lawrenceville, GA 30043-3264

Mailing address

1753 Azalea Dr
Lawrenceville, GA 30043-3264
Phone (770) 682-3753

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1508094855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1753 AZALEA DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433264",
            "telephone_number": "770-682-3753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1753 AZALEA DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433264",
            "telephone_number": "770-682-3753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AZARIA PERSONAL CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-25",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "PERTEA",
        "authorized_official_first_name": "STELUTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-682-3753",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CNA"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "GA",
            "license": "067013581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.