Big Mama House

Primary specialty

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

Legal business name

BIG MAMA HOUSE

Practice address

707 Pennybrook LN
Stone Mountain, GA 30087-5918

Phone

(404) 538-6074

NPI assigned

Jun 17, 2015

Organization subpart

No

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

Authorized official

Name

Hanniyah Abdul Aziz

Title

Ceo/Owner

Phone

(404) 538-6074

Specialties & licenses 2

Addresses

Tax ID family

Big Mama House2 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.

• Big Mommas' House PCH Inc

  • Home Health Agency
  • Lithonia, GA
  • NPI 1578892774
  NPD tax ID

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434499200000",
    "number": "1659752491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 PENNYBROOK LN",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300875918",
            "telephone_number": "404-538-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 PENNYBROOK LN",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300875918",
            "telephone_number": "404-538-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG MAMA HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A",
        "authorized_official_last_name": "ABDUL AZIZ",
        "authorized_official_first_name": "HANNIYAH",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "404-538-6074"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Stone Mountain, GA
• Providers in Stone Mountain, 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 Jun 17, 2015; 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.