Jmanor LLR

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

060-02-046-1 Issued in GA

Legal business name

JMANOR LLR

Doing business as

JManor Senior Living

Practice address

11905 Harris Rd
Roswell, GA 30076-1113

Phone

(770) 298-8439

Fax

(770) 298-8439

NPI assigned

Nov 3, 2017

Last updated

Nov 3, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

James Graft

Title

Owner/Administrator

Phone

(770) 298-8439

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• JManor Senior Living Doing business as

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509667200000",
    "number": "1629580204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BAY COLT RD",
            "city": "MILTON",
            "state": "GA",
            "postal_code": "300093529",
            "telephone_number": "770-298-8439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11905 HARRIS RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761113",
            "telephone_number": "770-298-8439",
            "fax_number": "770-298-8439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JMANOR LLR",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2017-11-03",
        "status": "A",
        "authorized_official_last_name": "GRAFT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "770-298-8439"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "060-02-046-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CARE HOME LICENSE",
            "identifier": "060-02-046-1",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JManor Senior Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Brian Douglas Johnson, DMD

• Assisted Living Facility in Roswell, GA
• Providers in Roswell, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 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.