Proactive Development Care

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROACTIVE DEVELOPMENT CARE

Practice address

5195 Cotter Court
Union City, GA 30291

Phone

(470) 691-9269

NPI assigned

Jul 10, 2024

Organization subpart

No

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

Authorized official

Name

Phlythia C ClecklerNPI 1366225716

Title

Owner

Phone

(470) 691-9269

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phlythia Clarissa Cleckler

  • Home Health Aide
  • Union City, GA
  • NPI 1366225716
  NPD Authorized official

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

{
    "created_epoch": "1720569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720569600000",
    "number": "1962249706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5195 COTTER COURT",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "30291",
            "telephone_number": "470-691-9269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5195 COTTER COURT",
            "city": "UNION CITY",
            "state": "GA",
            "postal_code": "30291",
            "telephone_number": "470-691-9269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE DEVELOPMENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-10",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-09",
        "status": "A",
        "authorized_official_last_name": "CLECKLER",
        "authorized_official_first_name": "PHLYTHIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-691-9269"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Union City, GA
• Providers in Union City, GA by specialty
• Home Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.