NPIMap

Organization Active NPI

Marion'S Personal Care Home

  • Adult Care Home Facility
  • Loganville, GA
National Provider Identifier
1902108558
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
2010008278 Issued in GA
Legal business name
MARION'S PERSONAL CARE HOME
Practice address
942 Preserve Park Dr
Loganville, GA 30052-8315
Phone
(404) 578-2615
NPI assigned
Dec 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Authorized official

Name
Merlyn Kirk
Title
Owner
Phone
(404) 578-2615

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X 2010008278 GA Primary

Addresses

Primary practice location

942 Preserve Park Dr
Loganville, GA 30052-8315

Mailing address

942 Preserve Park Dr
Loganville, GA 30052-8315
Phone (404) 578-2615

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1902108558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 PRESERVE PARK DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300528315",
            "telephone_number": "404-578-2615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 PRESERVE PARK DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300528315",
            "telephone_number": "404-578-2615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARION'S PERSONAL CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "KIRK",
        "authorized_official_first_name": "MERLYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-578-2615"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "GA",
            "license": "2010008278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; 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.