Cedar Communities at Stone Mountain, LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

CEDAR COMMUNITIES AT STONE MOUNTAIN, LLC

Practice address

1745 Parke Plaza Cir
Stone Mountain, GA 30087-3498

Phone

(770) 689-4800

NPI assigned

Oct 23, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Nicholas Terzulli, ESQ.

Title

General Counsl

Phone

(646) 428-3270

Specialties & licenses 1

Addresses

Other names 1

• Brookside Stone Mountain Doing business as

Locations

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

{
    "created_epoch": "1698019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698019200000",
    "number": "1609648773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 FRANKLIN AVE STE 325",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115301693",
            "telephone_number": "646-428-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1745 PARKE PLAZA CIR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873498",
            "telephone_number": "770-689-4800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR COMMUNITIES AT STONE MOUNTAIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-23",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A",
        "authorized_official_last_name": "TERZULLI",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "GENERAL COUNSL",
        "authorized_official_telephone_number": "646-428-3270",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brookside Stone Mountain",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Corrine Carter
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• Madhusudan Chandora, M.D.
• Change Agents Counseling & Consulting, LLC

• All providers in Stone Mountain, GA
• Nursing Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.