SHIRLEY HOME AWAY FROM HOME
NPI 1457684482
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Fayetteville, GA

Q: What is Shirley Home Away From Home's NPI number?

The NPI number for Shirley Home Away From Home is 1457684482. It was assigned to this organization in the NPPES registry on September 9, 2009.

Q: What is Shirley Home Away From Home's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

Active since September 09, 2009

190 MIDDLING LN, FAYETTEVILLE, GA 30214(678) 557-2207 Get Directions Write a Review

NPPES record last updated: September 9, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Shirley Home Away From Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHIRLEY HOME AWAY FROM HOME (NPI 1457684482) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Fayetteville, Georgia and active in the NPI registry since September 2009. The organization lists Shirley Wilson, Administrator, as its authorized official.

NPPES Registry Identity

NPI1457684482

Entity TypeOrganization

Primary Taxonomy320900000X

Legal Business NameSHIRLEY HOME AWAY FROM HOME

Location Address190 MIDDLING LNFayetteville, GA 30214-3767

Mailing Address190 Middling LnFayetteville, GA 30214-3767

Phone(678) 557-2207

Organization SubpartNo

Authorized OfficialShirley WilsonAdministrator · (678) 557-2207

Enumeration DateSeptember 9, 2009

✔ NPI 1457684482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities

Taxonomy Code320900000X

License✔ Licensed in GA · 056-01-011-1

Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.

190 MIDDLING LN, Fayetteville, GA 30214

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Other Identifiers 1

Medicaid155482054BGA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shirley Home Away From Home's NPI number?

The NPI number for Shirley Home Away From Home is 1457684482. It was assigned to this organization in the NPPES registry on September 9, 2009.

Where is Shirley Home Away From Home located?

Shirley Home Away From Home is located at 190 Middling Ln, Fayetteville, GA 30214. The listed phone number is (678) 557-2207.

What is Shirley Home Away From Home's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Shirley Home Away From Home was last updated on September 9, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.