NPIMap

Organization Active NPI

Skylark Adh-Johns Creek, LLC

  • Adult Day Care Clinic/Center
  • Suwanee, GA
National Provider Identifier
1548701006
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
ADC000089 Issued in GA
Legal business name
SKYLARK ADH-JOHNS CREEK, LLC
Doing business as
Skylark Adult Day Center of Johns Creek
Practice address
4265 Johns Creek Pkwy Ste B
Suwanee, GA 30024-6038
Phone
(770) 476-8400
Fax
(678) 646-0602
NPI assigned
Mar 16, 2017
Organization subpart
Yes
Parent organization
SKYLARK SENIOR CARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

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

Authorized official

Name
Mr. Edwin Howard Morgens
Title
Ceo
Phone
(770) 476-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X ADC000089 GA Primary

Addresses

Primary practice location

4265 Johns Creek Pkwy Ste B
Suwanee, GA 30024-6038

Mailing address

4265 Johns Creek Pkwy Ste B
Suwanee, GA 30024-6038
Phone (770) 476-8400

Other identifiers 3

IdentifierTypeStateIssuer
383600128AMedicaidGA
718343569AMedicaidGA
383600128BMedicaidGA

Other names 1

  • Skylark Adult Day Center of Johns Creek Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1489622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489622400000",
    "number": "1548701006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4265 JOHNS CREEK PKWY STE B",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246038",
            "telephone_number": "770-476-8400",
            "fax_number": "678-646-0602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4265 JOHNS CREEK PKWY STE B",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246038",
            "telephone_number": "770-476-8400",
            "fax_number": "678-646-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLARK ADH-JOHNS CREEK, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SKYLARK SENIOR CARE, LLC",
        "enumeration_date": "2017-03-16",
        "last_updated": "2017-03-16",
        "status": "A",
        "authorized_official_last_name": "MORGENS",
        "authorized_official_first_name": "EDWIN",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-476-8400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "GA",
            "license": "ADC000089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "383600128A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "718343569A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "383600128B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skylark Adult Day Center of Johns Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; 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.