NPIMap

Organization Active NPI

Heavens Cove

  • Substance Abuse Rehabilitation Facility
  • Atlanta, GA
National Provider Identifier
1538314810
Registry record updated Nov 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
060-682 Issued in GA
Legal business name
HEAVENS COVE
Practice address
2049 Perkerson Rd SW
Atlanta, GA 30310-5052
Phone
(678) 499-4429
NPI assigned
Nov 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2008

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

Authorized official

Name
Andrea Moore
Title
Ceo
Phone
(678) 499-4429

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 060-682 GA Primary

Addresses

Primary practice location

2049 Perkerson Rd SW
Atlanta, GA 30310-5052

Mailing address

13295 Providence Lake Dr
Alpharetta, GA 30004-7507
Phone (678) 499-4429

Other identifiers 2

IdentifierTypeStateIssuer
291203416BMedicaidGA
291203416AMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Heaven's Cove I - IV LLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1228003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228003200000",
    "number": "1538314810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13295 PROVIDENCE LAKE DR",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300047507",
            "telephone_number": "678-499-4429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2049 PERKERSON RD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303105052",
            "telephone_number": "678-499-4429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENS COVE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-30",
        "last_updated": "2008-11-30",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-499-4429"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "GA",
            "license": "060-682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291203416B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291203416A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2008; 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.