Georgia Regional Health Services LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

GEORGIA REGIONAL HEALTH SERVICES LLC

Practice address

3731 Lake Pass LN
Suwanee, GA 30024-8422

Phone

(404) 914-3197

NPI assigned

Sep 30, 2020

Organization subpart

No

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

Authorized official

Name

Kali Fontaine

Title

Ceo

Phone

(404) 914-3197

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1689281982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 465483",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300425483",
            "telephone_number": "404-914-3197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3731 LAKE PASS LN",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300248422",
            "telephone_number": "404-914-3197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA REGIONAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "FONTAINE",
        "authorized_official_first_name": "KALI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "404-914-3197"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing 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 Sep 30, 2020; 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.