Celine'S Family Service, Inc

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

4279373712500 Issued in GA

Legal business name

CELINE'S FAMILY SERVICE, INC

Practice address

6440 Old Hillandale Dr
Lithonia, GA 30058-7672

Phone

(770) 315-5146

NPI assigned

Aug 28, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Sandra Leavell

Title

Executive Officer

Phone

(770) 315-5146

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188259200000",
    "number": "1700070398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 DOE VALLEY DR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300586203",
            "telephone_number": "770-315-5146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 OLD HILLANDALE DR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587672",
            "telephone_number": "770-315-5146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CELINE'S FAMILY SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A",
        "authorized_official_last_name": "LEAVELL",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "770-315-5146",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "GA",
            "license": "4279373712500",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "GA",
            "license": "4279373712500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "835780359A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Mental Illness Community Based Residential Treatment Facility in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Mental Illness Community Based Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; 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.