K'S House

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

K'S HOUSE

Practice address

5556 Shoshone Pass
Ellenwood, GA 30294-6677

Phone

(770) 474-5800

Fax

(770) 474-6444

NPI assigned

Nov 2, 2010

Organization subpart

No

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

Authorized official

Name

Kaye S Crumbley

Title

Owner/Director

Phone

(770) 474-5800

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288656000000",
    "number": "1972803310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5556 SHOSHONE PASS",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "30294",
            "telephone_number": "770-474-5800",
            "fax_number": "770-474-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5556 SHOSHONE PASS",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302946677",
            "telephone_number": "770-474-5800",
            "fax_number": "770-474-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K'S HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-02",
        "last_updated": "2010-11-02",
        "status": "A",
        "authorized_official_last_name": "CRUMBLEY",
        "authorized_official_first_name": "KAYE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "770-474-5800"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "667111020A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Ellenwood, GA
• Providers in Ellenwood, 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 Nov 2, 2010; 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.