NPIMap

Organization Active NPI

Ebony Healthcare Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Savannah, GA
National Provider Identifier
1679196349
Registry record updated Mar 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
EBONY HEALTHCARE SERVICES
Practice address
169 Parkview Rd
Savannah, GA 31419-9671
Phone
(912) 677-8231
Fax
(888) 494-4209
NPI assigned
May 28, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2021

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

Authorized official

Name
Kimberly Davis
Title
Credentialing Specialists
Phone
(912) 484-3879

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 164W00000X
In Home Supportive Care Agency 253Z00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

169 Parkview Rd
Savannah, GA 31419-9671

Mailing address

169 Parkview Rd
Savannah, GA 31419-9671
Phone (912) 677-8231

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL General Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616025600000",
    "number": "1679196349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 PARKVIEW RD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314199671",
            "telephone_number": "912-677-8231",
            "fax_number": "888-494-4209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 PARKVIEW RD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314199671",
            "telephone_number": "912-677-8231",
            "fax_number": "888-494-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBONY HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-28",
        "last_updated": "2021-03-18",
        "certification_date": "2021-03-18",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALISTS",
        "authorized_official_telephone_number": "912-484-3879"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Licensed Practical Nurse",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "General",
            "affiliation": "N",
            "endpointDescription": "General",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "Wording",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "General",
            "address_1": "169 Parkview Rd",
            "city": "Savannah",
            "state": "GA",
            "country_code": "US",
            "postal_code": "314199671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; 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.