Christian City Convalescent Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NHA004005 Issued in GA

Legal business name

CHRISTIAN CITY CONVALESCENT CENTER

Practice address

7300 Lester Rd
Union City, GA 30291-2328

Phone

(770) 964-3301

NPI assigned

Sep 27, 2005

Last updated

Aug 22, 2020By 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. Bruce R. Erickson

Title

Administrator

Phone

(770) 703-2611

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871589580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 LESTER RD",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912328",
            "telephone_number": "770-964-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 LESTER RD",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "302912328",
            "telephone_number": "770-964-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN CITY CONVALESCENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-703-2611",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "NHA004005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE/UNITED HEALTH CA",
            "identifier": "71-00122",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caison Staffing LLC
• Andrea Davis Camp, M.ED., CCC-SLP
• Constance Causer, PSYD
• Celebrity Body Sculpting and Cosmetic Surgery Center
• Dante Charles I
• Shawanda B Clarke, BA, M.ED
• Phlythia Clarissa Cleckler
• Samuel Clifton, MS, CCC-SLP
• Yolanda Redona Coates, LPC
• Cotter Personal Care Home LLC

• Skilled Nursing Facility in Union City, GA
• Providers in Union City, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.