Ekd Family Services

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

Legal business name

EKD FAMILY SERVICES

Practice address

1581 Summit Pond Rd
Loganville, GA 30052-5473

Phone

(678) 344-6602

NPI assigned

Sep 6, 2012

Organization subpart

Yes

Parent organization

EKD COMMUNITY OPPORTUNITY CENTERAs reported in NPPES

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

Authorized official

Name

Ms. Eula Berassa, B.S.

Title

Administrator

Phone

(404) 933-7223

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1346889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346889600000",
    "number": "1689923534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1581 SUMMIT POND RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300525473",
            "telephone_number": "678-344-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1581 SUMMIT POND RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300525473",
            "telephone_number": "678-344-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EKD FAMILY SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EKD COMMUNITY OPPORTUNITY CENTER",
        "enumeration_date": "2012-09-06",
        "last_updated": "2012-09-06",
        "status": "A",
        "authorized_official_last_name": "BERASSA",
        "authorized_official_first_name": "EULA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "404-933-7223",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.S."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "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 6, 2012; 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.