Cherokee Angel Senior Care & Training Center

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

ADC000107 Issued in GA

Legal business name

CHEROKEE ANGEL SENIOR CARE & TRAINING CENTER

Practice address

2442 Marietta Hwy
Suite 100
Canton, GA 30114-4023

Phone

(404) 918-3066

NPI assigned

Oct 6, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Dominique R Louis

Title

Owner

Phone

(404) 918-3066

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1444089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444089600000",
    "number": "1871963553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2442 MARIETTA HWY",
            "address_2": "SUITE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301144023",
            "telephone_number": "404-918-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2442 MARIETTA HWY",
            "address_2": "SUITE 100",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301144023",
            "telephone_number": "404-918-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHEROKEE ANGEL SENIOR CARE & TRAINING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-06",
        "last_updated": "2015-10-06",
        "status": "A",
        "authorized_official_last_name": "LOUIS",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-918-3066",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "GA",
            "license": "ADC000107",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003152115A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003152115C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003130496A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzan Charon, RPH
• Swapan K Chaudhuri, MD
• Jonathan Arthur Cheek, MD
• Anastasiya Yuryevna Chekerenda, PA-C
• Victor W Chen, MD
• Cherokee Center for Nursing and Healing LLC
• Cherokee Children'S Dentistry
• Cherokee County Board of Commissioners
• Cherokee County Health Department
• Cherokee County Health Department

• All providers in Canton, GA
• Adult Care Home Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2015; 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.