Georgia Pals, Inc

Primary specialty

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

Legal business name

GEORGIA PALS, INC

Practice address

3336 Willow Ridge Cir SW
Gainesville, GA 30504-5656

Phone

(770) 967-9969

Fax

(770) 965-7335

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Mario E Tosta

Title

Administrator

Phone

(770) 967-9969

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891822722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3336 WILLOW RIDGE CIR SW",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305045656",
            "telephone_number": "770-967-9969",
            "fax_number": "770-965-7335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3336 WILLOW RIDGE CIR SW",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305045656",
            "telephone_number": "770-967-9969",
            "fax_number": "770-965-7335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA PALS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TOSTA",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-967-9969"
    },
    "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 Gainesville, GA
• Providers in Gainesville, 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 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.