The Family Center of South Dekalb, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THE FAMILY CENTER OF SOUTH DEKALB, LLC

Practice address

5000 Snapfinger Woods Dr
Suite C-100
Decatur, GA 30035-4085

Phone

(678) 418-0890

Fax

(678) 418-0892

NPI assigned

Dec 29, 2008

Last updated

Dec 29, 2008By 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. Mia Yvonne Wright, BSW, MS, MBANPI 1245649581

Title

Program Manager

Phone

(770) 875-5504

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Family Center of South Dekalb LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Family Center of South Dekalb, LLC

  • Community/Behavioral Health Agency
  • Decatur, GA
  • NPI 1518101146
  NPD tax ID

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.

• Mia Y Wright, MBA, LCSW

  • Clinical Social Worker
  • Peachtree City, GA
  • NPI 1245649581
  Authorized official Same address or phone

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

{
    "created_epoch": "1230508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230508800000",
    "number": "1700022571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 SNAPFINGER WOODS DR",
            "address_2": "SUITE C-100",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354085",
            "telephone_number": "678-418-0890",
            "fax_number": "678-418-0892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 SNAPFINGER WOODS DR",
            "address_2": "SUITE C-100",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300354085",
            "telephone_number": "678-418-0890",
            "fax_number": "678-418-0892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FAMILY CENTER OF SOUTH DEKALB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-29",
        "last_updated": "2008-12-29",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "MIA",
        "authorized_official_middle_name": "YVONNE",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "770-875-5504",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BSW, MS, MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "967590362A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• The Elim Community Development Center
• The Emory Clinic
• The Emory Clinic Inc (Emory Endoscopy Center at Decatur)
• The Emory Clinic Pediatric Providers
• The Eyecare Studio, LLC
• The Foster Care Alliance
• The Fountain of Hope Counseling Services,LLC
• The IV Spot, LLC.
• The Joy of Care LLC
• The Kroger Co (Kroger Pharmacy)

• Community/Behavioral Health Agency in Decatur, GA
• Providers in Decatur, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; 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.