Distinctively Yours of Georgia, Inc

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

Legal business name

DISTINCTIVELY YOURS OF GEORGIA, INC

Practice address

8435 Magnolia Dr
Jonesboro, GA 30238-3132

Phone

(770) 507-0125

Fax

(770) 507-9075

NPI assigned

Apr 29, 2013

Organization subpart

No

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

Authorized official

Name

Ms. Cynthia N Warner

Title

Director/Ceo

Phone

(770) 507-0125

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430179200000",
    "number": "1760827190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8435 MAGNOLIA DR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302383132",
            "telephone_number": "678-479-9462",
            "fax_number": "770-507-9075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8435 MAGNOLIA DR",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302383132",
            "telephone_number": "770-507-0125",
            "fax_number": "770-507-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCTIVELY YOURS OF GEORGIA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-29",
        "last_updated": "2015-04-28",
        "status": "A",
        "authorized_official_last_name": "WARNER",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "DIRECTOR/CEO",
        "authorized_official_telephone_number": "770-507-0125",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003108953B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003108953E",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003108953D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanavia Natae Dickerson
• Tiajuana Dillard, LCSW
• Khanh T. Dinh, D.C.
• Michele Renee Dionne, MD
• Rose Marie Distefano, PHARMACIST
• Nash Ditmetaroj, OD
• Divine Speech and Language Services Inc
• Karen Dixon, CSA
• Naquita Dobbs
• Katrina Marie Dodson

• Assisted Living Facility (Behavioral Disturbances) in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Assisted Living Facility (Behavioral Disturbances) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2015; 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.