Owls Retreat Inc.

Primary specialty

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

Legal business name

OWLS RETREAT INC.

Practice address

2858 Santa Barbara Dr
Decatur, GA 30032-3552

Phone

(404) 288-4782

NPI assigned

Jul 2, 2010

Last updated

Jul 2, 2010By 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

Ms. Onethia Logan

Title

Owner/Director

Phone

(404) 288-4782

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1278028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1922310291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2858 SANTA BARBARA DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300323552",
            "telephone_number": "404-288-4782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2858 SANTA BARBARA DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300323552",
            "telephone_number": "404-288-4782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OWLS RETREAT INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-02",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "ONETHIA",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "404-288-4782",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000888511B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles L Owen Jr., PT, DPT, OCS, CSCS
• Marion K Owen, M.D.
• Audrey L Owens Day, PHD
• Eileen Marie Owens, LPN
• Shanteria Owens, PHD
• Olufunmi Rachael Oyewumi
• Maureen Nnenna Ozim, NURSE PRACTITIONER
• Leslye Howell Pace, M.D.
• Hailey Christine Wetta Pachciarz, PA-C
• Guadalupe Rosario Pacheco, DC

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Decatur, GA
• Providers in Decatur, 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 2, 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.