CHARITY COMMUNITY LIVING ARRANGEMENT LLC NPI 1396144408

NPI Information

NPI: 1396144408
Provider Name: CHARITY COMMUNITY LIVING ARRANGEMENT LLC

Former Legal Business Name: CHARITY PERSONAL CARE HOME LLC

Classification: Student in an Organized Health Care Education/Training Program - 390200000X
Entity Type: Organization
Address:
2995 GARNET WAY
COLLEGE PARK, GA
ZIP 30349
Phone: (404) 519-5248
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CHARITY COMMUNITY LIVING ARRANGEMENT LLC is a student in an organized health care education training program in College Park, GA. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. CHARITY COMMUNITY LIVING ARRANGEMENT LLC NPI is 1396144408. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Charity Personal Care Home Llc.

The provider's business location address is:

2995 GARNET WAY
COLLEGE PARK, GA
ZIP 30349
Phone: (404) 519-5248

The provider's authorized official is Charity Chinasa Ekperi .
The authorized official title is Ceo and has the following contact phone number (404) 519-5248.

The enumeration date for this NPI number is 8/14/2014 and was last updated on 8/14/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program		CLA002141	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	674871532A	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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