NPIMap

Organization Active NPI

Dekalb County Board of Health

  • Public Health or Welfare Agency
  • Lithonia, GA
National Provider Identifier
1750488052
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
DEKALB COUNTY BOARD OF HEALTH
Practice address
2612 Max Cleland Blvd Ste a
Lithonia, GA 30058-4400
Phone
(678) 526-5429
Fax
(678) 526-5434
NPI assigned
Sep 20, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Sandra E Bouchelion, MD
Title
District Director/Ceo
Phone
(404) 294-3787

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

2612 Max Cleland Blvd Ste a
Lithonia, GA 30058-4400

Mailing address

445 Winn Way
PO Box 987
Decatur, GA 30030-1707
Phone (404) 294-3701

Other names 1

  • East Teen Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Dekalb County Mental HL8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2612 Max Cleland Blvd
Ste A
Lithonia, GA 30058
Phone (678) 526-5429

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750488052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 WINN WAY",
            "address_2": "PO BOX 987",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301707",
            "telephone_number": "404-294-3701",
            "fax_number": "404-508-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2612 MAX CLELAND BLVD STE A",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300584400",
            "telephone_number": "678-526-5429",
            "fax_number": "678-526-5434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB COUNTY BOARD OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOUCHELION",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DISTRICT DIRECTOR/CEO",
        "authorized_official_telephone_number": "404-294-3787",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Teen Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lithonia, GA

Sources for this page

  • 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.