Positive Care Personal Care Home, Inc

Primary specialty

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

License

075-R-0350 Issued in GA

Legal business name

POSITIVE CARE PERSONAL CARE HOME, INC

Practice address

210 Willis Dr
Stockbridge, GA 30281-7272

Phone

(770) 507-0123

Fax

(770) 507-7021

NPI assigned

Jul 7, 2017

Organization subpart

No

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

Authorized official

Name

Ms. Mary L Williams

Title

Executive Director

Phone

(678) 467-1087

Specialties & licenses 1

Addresses

Other names 2

• Positive Care Private Home Care, Inc Doing business as
• Robert R. Williams Center for Veteran Rehabilitation and Aid Doing business as

Tax ID family

Positive Care Personal Care Home Inc2 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.

• Positive Care Personal Care Home, Inc

  • Home Health Agency
  • Stockbridge, GA
  • NPI 1508546961
  NPD tax ID

Locations

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1730601121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WILLIS DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817272",
            "telephone_number": "770-507-0123",
            "fax_number": "770-507-7021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WILLIS DR",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302817272",
            "telephone_number": "770-507-0123",
            "fax_number": "770-507-7021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 Willis Dr",
            "address_purpose": "LOCATION",
            "city": "Stockbridge",
            "state": "GA",
            "postal_code": "302817272",
            "country_code": "US",
            "telephone_number": "770-507-0123",
            "fax_number": "770-507-7021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "POSITIVE CARE PERSONAL CARE HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-07",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "678-467-1087",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "075-R-0350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Positive Care Private Home Care, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Positive Care Private Home Care, Inc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Robert R. Williams Center for Veteran Rehabilitation and Aid",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary V Poore, L.C.S.W
• Jake J Porter III, M.D., MPH
• Karen Anne Porter, P.T.
• Sandra Porter, LPC, NCC
• Positive Care Personal Care Home, Inc
• Post Bump Doula Services
• Keyanne Potter
• Valeria Dixon Powell, LPN
• Ellie Morgan Gray Powner
• Rayasam V. Prasad, M.D.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Stockbridge, GA
• Providers in Stockbridge, 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 Oct 12, 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.