Urban Temple Studio 107

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

License

007007 Issued in GA

Legal business name

URBAN TEMPLE STUDIO 107

Practice address

1867 Lawrenceville Hwy
Decatur, GA 30033-5729

Phone

(404) 600-5624

NPI assigned

Jul 11, 2013

Last updated

Jul 11, 2013By 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

Qiana L Gordon, LMT

Title

Owner

Phone

(404) 600-5624

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1373500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373500800000",
    "number": "1760823256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1867 LAWRENCEVILLE HWY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335729",
            "telephone_number": "404-600-5624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1867 LAWRENCEVILLE HWY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300335729",
            "telephone_number": "404-600-5624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "URBAN TEMPLE STUDIO 107",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-11",
        "last_updated": "2013-07-11",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "QIANA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-600-5624",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GA",
            "license": "007007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Unique Healthcare & Wellness Center, LLC
• United Ambulance Services LLC
• United Rehab Inc. (United Rehab of Decatur)
• Universal Community Pharmacy
• Efemena Unyove, RPH
• Kristopher Nicholas Urbanovitch
• Steven Ira Urken, M.D.
• US Department of Veterans Affairs
• USA Vascular Center of Decatur LLC
• USA Vein Clinics of Decatur LLC

• Case Management Agency in Decatur, GA
• Providers in Decatur, GA by specialty
• Case Management Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; 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.