The Elim Community Development Center

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

THE ELIM COMMUNITY DEVELOPMENT CENTER

Practice address

4717 Covington Hwy
Suite 109
Decatur, GA 30035-2015

Phone

(470) 658-9284

NPI assigned

Oct 3, 2016

Last updated

Oct 3, 2016By 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

Mr. Osborne J Giles Sr.

Title

Ceo

Phone

(470) 658-9284

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475452800000",
    "number": "1851840797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2714 WATERFORD CLUB DR",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301224413",
            "telephone_number": "470-658-9284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4717 COVINGTON HWY",
            "address_2": "SUITE 109",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300352015",
            "telephone_number": "470-658-9284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE ELIM COMMUNITY DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A",
        "authorized_official_last_name": "GILES",
        "authorized_official_first_name": "OSBORNE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "470-658-9284",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Decatur, GA
• Providers in Decatur, GA by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.