Emerald Isles PCH, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

EMERALD ISLES PCH, INC

Practice address

1402 Shadowbrook Dr
Marietta, GA 30062-4032

Phone

(770) 509-0533

NPI assigned

Mar 26, 2008

Last updated

Mar 26, 2008By 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

Marian Lawton

Title

Facility Director

Phone

(770) 509-0533

Specialties & licenses 3

Addresses

Other identifiers 2

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1821260217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 SHADOWBROOK DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300624032",
            "telephone_number": "770-509-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 SHADOWBROOK DR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300624032",
            "telephone_number": "770-509-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERALD ISLES PCH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "LAWTON",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_title_or_position": "FACILITY DIRECTOR",
        "authorized_official_telephone_number": "770-509-0533"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "244",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "088",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Marietta, GA
• Providers in Marietta, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.