Butler-Bowden Personal Care Home, Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

044-01-294-2 Issued in GA

Legal business name

BUTLER-BOWDEN PERSONAL CARE HOME, INC

Practice address

694 Leighton Way
Stone Mountain, GA 30088-1829

Phone

(770) 498-6381

Fax

(770) 413-9447

NPI assigned

Apr 11, 2007

Last updated

Jun 7, 2010By 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. Margaret J. Bowden

Title

Director

Phone

(770) 498-6381

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275868800000",
    "number": "1740404037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 LEIGHTON WAY",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300881829",
            "telephone_number": "770-498-6381",
            "fax_number": "770-413-9447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "694 LEIGHTON WAY",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300881829",
            "telephone_number": "770-498-6381",
            "fax_number": "770-413-9447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUTLER-BOWDEN PERSONAL CARE HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2010-06-07",
        "status": "A",
        "authorized_official_last_name": "BOWDEN",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "770-498-6381",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "GA",
            "license": "044-01-294-2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000917056A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000917056B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shundra Burnes, LCSW
• Jeffrey Burnett Sr., LDO
• Marinda Burns-Zanders, COTA/L
• Lisa Andrea Burrell, DMD
• Michael Burton
• Debrica Butler
• Eboni Byers
• Israel J Cabanas Jr.
• Cairo Trucking LLC
• Terence Chevez Caldwell, TRANSPORTATION

• Intellectual Disabilities Intermediate Care Facility in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Intellectual Disabilities Intermediate Care Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; 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.