Majestic Sunz Life Center

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

CLA001048

Legal business name

MAJESTIC SUNZ LIFE CENTER

Doing business as

Bolton Living Agency

Practice address

40 Lantana Way
Newnan, GA 30265-4171

Phone

(706) 569-1133

NPI assigned

Apr 14, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Zephaniah Dwayne Baker

Title

President

Phone

(706) 587-3906

Specialties & licenses 3

Addresses

Other names 1

• Bolton Living Agency Doing business as

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

{
    "created_epoch": "1365897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486512000000",
    "number": "1629411277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1091 BOLTON CT",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319062616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 LANTANA WAY",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302654171",
            "telephone_number": "706-569-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJESTIC SUNZ LIFE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-14",
        "last_updated": "2017-02-08",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "ZEPHANIAH",
        "authorized_official_middle_name": "DWAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-587-3906",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "038-R-1778",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "038-R-1778",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": "CLA001048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bolton Living Agency",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Newnan, GA
• Providers in Newnan, GA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia

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