Faith Dwellings, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

CLA001274 Issued in GA

Legal business name

FAITH DWELLINGS, INC.

Practice address

4666 Randalwood Dr
Stone Mountain, GA 30083-4350

Phone

(404) 343-4840

Fax

(678) 705-5512

NPI assigned

Jun 10, 2015

Last updated

Jun 10, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Andrea Teresa AsheNPI 1891174256

Title

Ceo/Administrator

Phone

(404) 578-6461

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Andrea Teresa Ashe

  • Community/Behavioral Health Agency
  • Stone Mountain, GA
  • NPI 1891174256
  NPD (past) Authorized official

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

{
    "created_epoch": "1433894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1699156216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4666 RANDALWOOD DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300834350",
            "telephone_number": "404-343-4840",
            "fax_number": "678-705-5512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4666 RANDALWOOD DR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300834350",
            "telephone_number": "404-343-4840",
            "fax_number": "678-705-5512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH DWELLINGS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-10",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "ASHE",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "TERESA",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "404-578-6461",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "CLA001274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "056582532A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.