Enersed Personal Care Home, Inc

Primary specialty

Respite CareTaxonomy code 385H00000X

Legal business name

ENERSED PERSONAL CARE HOME, INC

Practice address

3451 Springrun Dr
Decatur, GA 30032-6827

Phone

(404) 288-8026

NPI assigned

Oct 8, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Desrene Thompson

Title

President/Ceo

Phone

(404) 288-8026

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223424000000",
    "number": "1972754968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3451 SPRINGRUN DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300326827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 SPRINGRUN DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300326827",
            "telephone_number": "404-288-8026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENERSED PERSONAL CARE HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-08",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DESRENE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "404-288-8026",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000694053A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.