Claire Custom Care

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

CLAIRE CUSTOM CARE

Practice address

1452 Tether LN
McDonough, GA 30253-9210

Phone

(678) 233-8285

Fax

(844) 273-5942

NPI assigned

Oct 23, 2014

Organization subpart

No

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

Authorized official

Name

Sandra Angeus

Title

Ceo

Phone

(678) 233-8285

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1992100705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1452 TETHER LN",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302539210",
            "telephone_number": "678-233-8285",
            "fax_number": "844-273-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1452 TETHER LN",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302539210",
            "telephone_number": "678-233-8285",
            "fax_number": "844-273-5942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAIRE CUSTOM CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "ANGEUS",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-233-8285"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Kayla Clark
• Lucrethia Clark, OTR/L
• William Douglas Clark

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in McDonough, GA
• Providers in McDonough, GA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.