NPIMap

Organization Active NPI

Georgia Mountain Community Services

  • Developmentally Disabled Services Day Training Agency
  • Gainesville, GA
National Provider Identifier
1770647463
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
GEORGIA MOUNTAIN COMMUNITY SERVICES
Practice address
3509 Mabry Rd
Gainesville, GA 30504-5755
Phone
(678) 513-5700
Fax
(678) 513-5700
NPI assigned
Dec 20, 2006
Last updated
Jul 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Authorized official

Name
Karen R Tucker
Title
Billing Manager
Phone
(678) 513-5733

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X Primary

Addresses

Primary practice location

3509 Mabry Rd
Gainesville, GA 30504-5755

Mailing address

3509 Mabry Rd
Gainesville, GA 30504-5755
Phone (678) 513-5700

Other identifiers 1

IdentifierTypeStateIssuer
000624731AJMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
Avita Community Partners127 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1770647463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3509 MABRY RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305045755",
            "telephone_number": "678-513-5700",
            "fax_number": "678-513-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 MABRY RD",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305045755",
            "telephone_number": "678-513-5700",
            "fax_number": "678-513-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA MOUNTAIN COMMUNITY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "678-513-5733"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000624731AJ",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.