Bread of Life Assisted Living Corporation

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

BREAD OF LIFE ASSISTED LIVING CORPORATION

Practice address

2001 Martin Luther King Jr Dr SW
Suite 450-a
Atlanta, GA 30310-1101

Phone

(678) 732-8191

Fax

(404) 564-6487

NPI assigned

Aug 21, 2012

Organization subpart

No

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

Authorized official

Name

Mrs. Christine Nwankwo

Title

Executive Director

Phone

(678) 732-8191

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345507200000",
    "number": "1861740904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 MARTIN LUTHER KING JR DR SW",
            "address_2": "SUITE 450-A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101101",
            "telephone_number": "678-732-8191",
            "fax_number": "404-564-6487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MARTIN LUTHER KING JR DR SW",
            "address_2": "SUITE 450-A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101101",
            "telephone_number": "678-732-8191",
            "fax_number": "404-564-6487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAD OF LIFE ASSISTED LIVING CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-21",
        "last_updated": "2012-08-21",
        "status": "A",
        "authorized_official_last_name": "NWANKWO",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "678-732-8191",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "GA",
            "license": null,
            "primary": true
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Assisted Living Facility (Mental Illness) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.