Samo Holdings, Inc

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

031013109 Issued in GA

Legal business name

SAMO HOLDINGS, INC

Practice address

5530 Swanson Rd
Ellenwood, GA 30294-3857

Phone

(404) 729-2514

Fax

(678) 264-5461

NPI assigned

Apr 11, 2011

Organization subpart

No

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

Authorized official

Name

Moses Demba

Title

Ceo

Phone

(404) 729-2514

Specialties & licenses 2

Addresses

Other names 1

• Amina's Home Other name

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302480000000",
    "number": "1598055691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2467 CHAUNCEY LN SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300644536",
            "telephone_number": "404-729-2514",
            "fax_number": "678-264-5461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 SWANSON RD",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302943857",
            "telephone_number": "404-729-2514",
            "fax_number": "678-264-5461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMO HOLDINGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-11",
        "last_updated": "2011-04-11",
        "status": "A",
        "authorized_official_last_name": "DEMBA",
        "authorized_official_first_name": "MOSES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-729-2514"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "GA",
            "license": "031013109",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "031013109",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amina's Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Mental Illness Community Based Residential Treatment Facility in Ellenwood, GA
• Providers in Ellenwood, GA by specialty
• Mental Illness Community Based Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.