Renee'S Personal Care Home, LLC

Primary specialty

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

License

121014201 Issued in GA

Legal business name

RENEE'S PERSONAL CARE HOME, LLC

Practice address

1916 Ohio Ave
Augusta, GA 30904-5329

Phone

(706) 869-0775

Fax

(706) 869-0775

NPI assigned

Jan 10, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Isaac T Miller

Title

Ceo

Phone

(706) 869-0775

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1294617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294617600000",
    "number": "1821392572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 888",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308090888",
            "telephone_number": "706-869-0775",
            "fax_number": "706-869-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1916 OHIO AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309045329",
            "telephone_number": "706-869-0775",
            "fax_number": "706-869-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEE'S PERSONAL CARE HOME, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-10",
        "last_updated": "2011-01-10",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ISAAC",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-869-0775",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "121014201",
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": "121014201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Augusta, GA
• Providers in Augusta, 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 Jan 10, 2011; 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.