Moore, Sharlene'S Personal Care Home, Inc.

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

CLA001018 Issued in GA

Legal business name

MOORE, SHARLENE'S PERSONAL CARE HOME, INC.

Practice address

1401 Belcher Lane
Bainbridge, GA 39818-8327

Phone

(229) 248-5955

Fax

(229) 248-8614

NPI assigned

Oct 1, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Sharlene Joyce Moore

Title

Ceo

Phone

(229) 248-5955

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1811248842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 BELCHER LANE",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398188327",
            "telephone_number": "229-248-5955",
            "fax_number": "229-248-8614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 BELCHER LANE",
            "city": "BAINBRIDGE",
            "state": "GA",
            "postal_code": "398188327",
            "telephone_number": "229-248-5955",
            "fax_number": "229-248-8614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE, SHARLENE'S PERSONAL CARE HOME, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "SHARLENE",
        "authorized_official_middle_name": "JOYCE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "229-248-5955",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "CLA001018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emilee Poppell Miller
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• Rebekah Lynn Mills, LCSW
• Roger Lynn Mills, DMD
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• Jason Belmont Moye, MD
• Mandy Sampson Moye, MD
• Mrs Homecare, Inc.
• George Joseph Myers IV, D.O.

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Bainbridge, GA
• Providers in Bainbridge, GA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.