Famcare Connect of Georgia LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FAMCARE CONNECT OF GEORGIA LLC

Practice address

1172 Old Salem Rd SE
Conyers, GA 30094-5944

Phone

(770) 633-8550

NPI assigned

Apr 6, 2015

Organization subpart

No

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

Authorized official

Name

Jessica Lane

Title

Director of Administration

Phone

(770) 633-8550

Specialties & licenses 4

Addresses

Other names 1

• FAMCare CONNECT Doing business as

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428278400000",
    "number": "1962897983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1172 OLD SALEM RD SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1172 OLD SALEM RD SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300945944",
            "telephone_number": "770-633-8550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMCARE CONNECT OF GEORGIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-06",
        "last_updated": "2015-04-06",
        "status": "A",
        "authorized_official_last_name": "LANE",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "DIRECTOR OF ADMINISTRATION",
        "authorized_official_telephone_number": "770-633-8550"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral 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": [
        {
            "organization_name": "FAMCare CONNECT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sylvia Faison
• Faith Fulfillment Centers
• Babajide O. Falana, M.D.
• Ekundayo Adedapo Falase, MD
• Keith James Fallon, PSY.D.
• Famcare Connect of South Carolina LLC
• Family & Occupational Medicine of Conyers
• Family 360 Incorporated
• Family Home Medical Equipment, LLC
• Family Issues and Solutions Inc

• All providers in Conyers, GA
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2015; 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.