The 90 Group, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

110-R-1162 Issued in GA

Legal business name

THE 90 GROUP, LLC

Doing business as

Astin Home Care

Practice address

1800 Phoenix Blvd Ste 400
Atlanta, GA 30349-5560

Phone

(770) 790-0012

Fax

(866) 205-6289

NPI assigned

Jul 31, 2013

Last updated

Aug 19, 2019By 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

Ms. Michele Lee Ellis-Williams, QDCP

Title

Owner

Phone

(770) 790-0012

Specialties & licenses 1

Addresses

Other names 1

• Astin Home Care Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1375228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566172800000",
    "number": "1841622925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 PHOENIX BLVD BLDG 400",
            "address_2": "SUITE 400 #16",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "30349",
            "telephone_number": "770-790-0012",
            "fax_number": "866-205-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 PHOENIX BLVD STE 400",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303495560",
            "telephone_number": "770-790-0012",
            "fax_number": "866-205-6289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Mulberry St",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "AL",
            "postal_code": "361061537",
            "country_code": "US",
            "telephone_number": "334-452-7178",
            "fax_number": "866-205-6289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE 90 GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-31",
        "last_updated": "2019-08-19",
        "status": "A",
        "authorized_official_last_name": "ELLIS-WILLIAMS",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-790-0012",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "QDCP"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "GA",
            "license": "110-R-1162",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CollegePark",
            "affiliation": "N",
            "endpointDescription": "Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1501 Mulberry St",
            "city": "Montgomery",
            "state": "AL",
            "country_code": "US",
            "postal_code": "361061537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Astin Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.