Jean Thelemaque Jr.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Practice address

3648 Chamblee Tucker Rd
#F
Atlanta, GA 30341-4403

Phone

(770) 493-7750

NPI assigned

Aug 11, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Breakthrough Recovery Outreach, LLC

  • Substance Abuse Rehabilitation Facility
  • Atlanta, GA
  • NPI 1982909503
  NPD (past)

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

{
    "created_epoch": "1470873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470873600000",
    "number": "1932653532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "743 HOLMES ST NW",
            "address_2": "#H",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303187684",
            "telephone_number": "347-595-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3648 CHAMBLEE TUCKER RD",
            "address_2": "#F",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303414403",
            "telephone_number": "770-493-7750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THELEMAQUE",
        "first_name": "JEAN",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-08-11",
        "last_updated": "2016-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Abuse Rehabilitation Facility in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Substance Abuse Rehabilitation Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2016; 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.