Gainesville Jaycees Vocational Rehab Center, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

GAINESVILLE JAYCEES VOCATIONAL REHAB CENTER, INC.

Doing business as

Rehabilitation Industries of N.E. GA

Practice address

930 Athens St
Gainesville, GA 30501-6937

Phone

(770) 535-7464

Fax

(770) 531-5697

NPI assigned

Jul 24, 2012

Last updated

Jul 24, 2012By 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

Mrs. Paula Phillips, MBA

Title

Executive Director

Phone

(770) 535-7464

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Rehabilitation Industries of N.E. GA Doing business as

Locations

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1922353234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 907413",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305010907",
            "telephone_number": "770-535-7464",
            "fax_number": "770-531-5697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 ATHENS ST",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305016937",
            "telephone_number": "770-535-7464",
            "fax_number": "770-531-5697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAINESVILLE JAYCEES VOCATIONAL REHAB CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-24",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "770-535-7464",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000800456A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehabilitation Industries of N.E. GA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.