Guardian Angels Adult Community Living LLC

Primary specialty

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

Legal business name

GUARDIAN ANGELS ADULT COMMUNITY LIVING LLC

Practice address

6672 Hill Creek CV
Lithonia, GA 30058-7001

Phone

(770) 666-4401

NPI assigned

Jul 5, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Cassandra Simone Hicks

Title

Health Systems Manager

Phone

(770) 666-4401

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309824000000",
    "number": "1861789380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6672 HILL CREEK CV",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587001",
            "telephone_number": "770-666-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6672 HILL CREEK CV",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587001",
            "telephone_number": "770-666-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUARDIAN ANGELS ADULT COMMUNITY LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-05",
        "last_updated": "2011-07-05",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "SIMONE",
        "authorized_official_title_or_position": "HEALTH SYSTEMS MANAGER",
        "authorized_official_telephone_number": "770-666-4401",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lithonia, GA
• Providers in Lithonia, 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 Jul 5, 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.