Greater Atlanta Youth Development Corporation

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

GREATER ATLANTA YOUTH DEVELOPMENT CORPORATION

Practice address

455 North Dr
Fayetteville, GA 30214-2628

Phone

(404) 593-9613

Fax

(770) 975-7732

NPI assigned

Sep 27, 2010

Organization subpart

No

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

Authorized official

Name

Mr. William Joseph Thomas Sr., BA, MA

Title

Executive Director

Phone

(404) 593-9613

Specialties & licenses 3

Addresses

Other names 1

• GAYDC Other name

Locations

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285545600000",
    "number": "1992014823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 ACWORTH OAKS DR NW",
            "address_2": "SUITE #200-PMB#123",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301016693",
            "telephone_number": "404-593-9613",
            "fax_number": "770-975-7732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 NORTH DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142628",
            "telephone_number": "404-593-9613",
            "fax_number": "770-975-7732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER ATLANTA YOUTH DEVELOPMENT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-27",
        "last_updated": "2010-09-27",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "404-593-9613",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "BA, MA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GAYDC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Skylar Rose Grant
• Latoya Gray
• Sharmane Marie Gray, MD
• Charlotte Elizabeth Grayson- Mathis, M.D.
• Christa Grayson, CADC-II
• Greater Georgia Behavioral Health
• Leshundra Green
• Neffera Green, RBT
• Wallace Maxwell Green, PAC
• Susanne Greenblatt, P.T.

• All providers in Fayetteville, GA
• Voluntary or Charitable Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.