NPIMap

Organization Active NPI

Georgia Mountains Community Services

  • Developmentally Disabled Services Day Training Agency
  • Gainesville, GA
National Provider Identifier
1639699705
Registry record updated Jun 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
GEORGIA MOUNTAINS COMMUNITY SERVICES
Practice address
1901 Columns Dr Apt 1901
Gainesville, GA 30504-5954
Phone
(770) 572-8395
NPI assigned
Jun 21, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2017

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

Authorized official

Name
Victor Bowers
Title
Cfo
Phone
(678) 513-5702

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

1901 Columns Dr Apt 1901
Gainesville, GA 30504-5954

Mailing address

4331 Thurmon Tanner Rd
Flowery Branch, GA 30542-2829
Phone (678) 513-5762

Other identifiers 1

IdentifierTypeStateIssuer
000607054CPMedicaidGA

Other names 1

  • Avita Community Services Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1498003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498003200000",
    "number": "1639699705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4331 THURMON TANNER RD",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305422829",
            "telephone_number": "678-513-5762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 COLUMNS DR APT 1901",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305045954",
            "telephone_number": "770-572-8395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA MOUNTAINS COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-21",
        "last_updated": "2017-06-21",
        "status": "A",
        "authorized_official_last_name": "BOWERS",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "678-513-5702"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000607054CP",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avita Community Services",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avita Community Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.