NPIMap

Organization Active NPI

The Calla Lily LLC

Doing business as The Social Wellness Club

  • Home Health Agency
  • Stockbridge, GA
National Provider Identifier
1679925838
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
13131 Issued in NC
Legal business name
THE CALLA LILY LLC
Doing business as
The Social Wellness Club
Practice address
670 Pathwood LN
Stockbridge, GA 30281-7787
Phone
(856) 625-1741
NPI assigned
Jul 11, 2016
Last updated
Jul 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Authorized official

Name
Doresha K BanksNPI 1760808398
Title
Founder
Phone
(856) 625-1741

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 13131 NC Primary

Addresses

Primary practice location

670 Pathwood LN
Stockbridge, GA 30281-7787

Mailing address

670 Pathwood LN
Stockbridge, GA 30281-7787
Phone (856) 625-1741

Other names 1

  • The Social Wellness Club Doing business as

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468195200000",
    "number": "1679925838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 PATHWOOD LN",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817787",
            "telephone_number": "856-625-1741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 PATHWOOD LN",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817787",
            "telephone_number": "856-625-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CALLA LILY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-11",
        "last_updated": "2016-07-11",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "DORESHA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "856-625-1741"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NC",
            "license": "13131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Social Wellness Club",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; 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.