Preeminent Living Personal Care Home

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

PREEMINENT LIVING PERSONAL CARE HOME

Practice address

4047 Round Stone TRL
Snellville, GA 30039-3351

Phone

(678) 559-4187

NPI assigned

Dec 17, 2015

Organization subpart

No

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

Authorized official

Name

Kendrick Cooper

Title

Administrator

Phone

(678) 559-4187

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450396800000",
    "number": "1669837696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4047 ROUND STONE TRL",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300393351",
            "telephone_number": "678-559-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4047 ROUND STONE TRL",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300393351",
            "telephone_number": "678-559-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREEMINENT LIVING PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-18",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "KENDRICK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "678-559-4187"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.