Classic Community Support Inc

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

CLASSIC COMMUNITY SUPPORT INC

Practice address

739 Main St
Suite 3
Stone Mountain, GA 30083-3087

Phone

(770) 498-0832

NPI assigned

Mar 29, 2007

Organization subpart

No

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

Authorized official

Name

Charles Martin

Title

Ceo Director

Phone

(770) 498-0832

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730209487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "739 MAIN ST",
            "address_2": "SUITE 3",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833087",
            "telephone_number": "770-498-0832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 MAIN ST",
            "address_2": "SUITE 3",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300833087",
            "telephone_number": "770-498-0832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC COMMUNITY SUPPORT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CEO DIRECTOR",
        "authorized_official_telephone_number": "770-498-0832"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Godwin Chukudi
• Eleanor Chung, LPN
• Sasha-Ann L Cisneros
• Ashley Victoria Clark, PTA
• Kim Meldrum Clarke
• Clemons Transport
• Avis Clemons
• Alasia Clinton
• Beatrice Clodomir, D.O.
• Desiree Nicole Cochran-Norfolk, CCS, CMAC, CAC II

• Developmentally Disabled Services Day Training Agency in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Developmentally Disabled Services Day Training Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.