Upper River Personal Care Home Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

UPPER RIVER PERSONAL CARE HOME INC

Practice address

130 Upper River Rd
Covington, GA 30016-3346

Phone

(770) 784-7757

NPI assigned

Sep 21, 2007

Last updated

Sep 21, 2007By 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

Mrs. Carol Mercedes Meikle McDonald

Title

President Administrator

Phone

(770) 784-7757

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1730375981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 UPPER RIVER RD",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300163346",
            "telephone_number": "770-784-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 UPPER RIVER RD",
            "city": "COVINGTON",
            "state": "GA",
            "postal_code": "300163346",
            "telephone_number": "770-784-7757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER RIVER PERSONAL CARE HOME INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "MEIKLE MCDONALD",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "MERCEDES",
        "authorized_official_title_or_position": "PRESIDENT  ADMINISTRATOR",
        "authorized_official_telephone_number": "770-784-7757",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Covington, GA
• Providers in Covington, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.