NPIMap

Organization Active NPI

Residential Living, Inc.

  • Community/Behavioral Health Agency
  • Jonesboro, GA
National Provider Identifier
1629365705
Registry record updated Jul 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
031011481 Issued in GA
Legal business name
RESIDENTIAL LIVING, INC.
Practice address
7861 Collinswood CT
Jonesboro, GA 30236-3399
Phone
(678) 927-7332
Fax
(678) 489-3009
NPI assigned
Jul 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2011

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

Authorized official

Name
Mrs. Valeria Broderick
Title
Owner
Phone
(678) 927-7332

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 031011481 GA Primary

Addresses

Primary practice location

7861 Collinswood CT
Jonesboro, GA 30236-3399

Mailing address

7861 Collinswood CT
Jonesboro, GA 30236-3399
Phone (678) 927-7332

National Provider Directory

National Provider Directory
Tax ID family
Residential Living Inc2 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": "1310083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310083200000",
    "number": "1629365705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7861 COLLINSWOOD CT",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302363399",
            "telephone_number": "678-927-7332",
            "fax_number": "678-489-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7861 COLLINSWOOD CT",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302363399",
            "telephone_number": "678-927-7332",
            "fax_number": "678-489-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL LIVING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-08",
        "last_updated": "2011-07-08",
        "status": "A",
        "authorized_official_last_name": "BRODERICK",
        "authorized_official_first_name": "VALERIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-927-7332",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "031011481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.