NPIMap

Organization Active NPI

Skylark Adh-Powers Ferry, LLC

Doing business as Skylark Adult Day Center of Cobb

  • Adult Day Care Clinic/Center
  • Atlanta, GA
National Provider Identifier
1568903805
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
ADC000088 Issued in GA
Legal business name
SKYLARK ADH-POWERS FERRY, LLC
Doing business as
Skylark Adult Day Center of Cobb
Practice address
120 Interstate North Pkwy East, SE
Suite 420
Atlanta, GA 30339-2164
Phone
(678) 741-3900
Fax
(678) 741-3901
NPI assigned
Mar 20, 2017
Last updated
Mar 20, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
SKYLARK SENIOR CARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 20, 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 ADC000088 GA Primary

Addresses

Primary practice location

120 Interstate North Pkwy East, SE
Suite 420
Atlanta, GA 30339-2164

Mailing address

120 Interstate North Parkway East, SE
Suite 420
Atlanta, GA 30339-2164
Phone (678) 741-3900

Other identifiers 3

IdentifierTypeStateIssuer
949972040AMedicaidGA
383600128CMedicaidGA
383600128DMedicaidGA

Other names 1

  • Skylark Adult Day Center of Cobb Doing business as

National Provider Directory

National Provider Directory

Locations

120 Interstate North Pkwy SE
Ste 420
Atlanta, GA 30339
Phone (678) 741-3900

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1568903805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 INTERSTATE NORTH PARKWAY EAST, SE",
            "address_2": "SUITE 420",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392164",
            "telephone_number": "678-741-3900",
            "fax_number": "678-741-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 INTERSTATE NORTH PKWY EAST, SE",
            "address_2": "SUITE 420",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392164",
            "telephone_number": "678-741-3900",
            "fax_number": "678-741-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLARK ADH-POWERS FERRY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SKYLARK SENIOR CARE, LLC",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "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": "ADC000088",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "949972040A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "383600128C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "383600128D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skylark Adult Day Center of Cobb",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Mar 20, 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.