CLOVER HOUSE, LLC
NPI 1043541915
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Rome, GA

Active since January 16, 2010
496 N AVERY RD NW, ROME, GA 30165(706) 295-2388(706) 413-1719 Get Directions Write a Review

NPPES record last updated: January 16, 2010. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Community Based Residential Treatment Fa...

About CLOVER HOUSE, LLC

This page provides the complete NPI Profile along with additional information for Clover House, Llc, a provider established in Rome, Georgia operating as a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The healthcare provider is registered in the NPI registry with number 1043541915 assigned on January 2010. The practitioner's primary taxonomy code is 320900000X with license number 057-01-039-1 (GA). The provider is registered as an organization and their NPI record was last updated 17 years ago. The authorized official of this NPI record is Mr. Darrell A Creel (Clover House Home Manager)

NPI
1043541915 Verify this NPI
Provider Name
CLOVER HOUSE, LLC
Entity Type
Organization
Location Address
496 N AVERY RD NW ROME, GA 30165
Location Phone
(706) 295-2388
Location Fax
(706) 413-1719
Mailing Address
496 N AVERY RD NW ROME, GA 30165
Mailing Phone
(706) 295-2388
Mailing Fax
(706) 413-1719
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
01-16-2010
Last Update Date
01-16-2010
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

Taxonomy Code
320900000X
Type
Residential Treatment Facilities
License No.
057-01-039-1
License State
GA
Taxonomy Description
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. DARRELL A CREEL

Authorized Official Title
CLOVER HOUSE HOME MANAGER
Authorized Official Phone
(706) 295-2388

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
247792228AMEDICAID (05)GA 

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1043541915, enumerated as an "organization" on January 16, 2010.

The provider is located at 496 N AVERY RD NW ROME, GA 30165 and the phone number is (706) 295-2388.

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.