JEREMY'S PLACE INC. NPI 1447877683

NPI Information

NPI: 1447877683
Provider Name: JEREMY'S PLACE INC.
Classification: Clinic/Center - 261QA0600X
Entity Type: Organization

Specialization: Adult Day Care

Address:
4910 JONESBORO RD STE 201
UNION CITY, GA
ZIP 30291
Phone: (770) 969-9334
Get Directions

JEREMY'S PLACE INC. is an adult day care clinic center in Union City, GA. JEREMY'S PLACE INC. NPI is 1447877683. The provider is registered as an organization entity type.

The provider's business location address is:

4910 JONESBORO RD STE 201
UNION CITY, GA
ZIP 30291-087
Phone: (770) 969-9334
Fax: (770) 969-9337

The provider's authorized official is Lateisha Nichol Jackson-brown .
The authorized official title is Owner and has the following contact phone number (770) 969-9334.

The enumeration date for this NPI number is 7/4/2020 and was last updated on 7/4/2020.

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	Primary
1	251C00000X	Day Training, Developmentally Disabled Services		No
2	251E00000X	Home Health		No
3	261QA0600X	Clinic/Center	Adult Day Care	Yes
4	261QD1600X	Clinic/Center	Developmental Disabilities	No
5	343900000X	Non-emergency Medical Transport (VAN)		No
6	253Z00000X	In Home Supportive Care		No

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
1	003203627B	MEDICAID	GEORGIA
2	003203627A	MEDICAID	GEORGIA
3	604196354A	MEDICAID	GEORGIA
4	604196354B	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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