NEW DOMUS PERSONAL CARE, LLC
NPI 1639377385
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in College Park, GA
- Organization
- Community Based Residential Treatment Fa...
About NEW DOMUS PERSONAL CARE, LLC
This page provides the complete NPI Profile along with additional information for New Domus Personal Care, Llc, a provider established in College Park, 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 1639377385 assigned on July 2007. The practitioner's primary taxonomy code is 320900000X with license number 060-01-256-2 (GA). The provider is registered as an organization and their NPI record was last updated 10 years ago. The authorized official of this NPI record is Mr. Jackie Othella Smith Jr. (Ceo)
- NPI
- 1639377385 Verify this NPI
- Provider Name
- NEW DOMUS PERSONAL CARE, LLC
- Entity Type
- Organization
- Location Address
- 2650 COLONIAL DR COLLEGE PARK, GA 30337
- Location Phone
- (404) 209-9296
- Mailing Address
- 6229 JOHNSON RD RIVERDALE, GA 30274
- Mailing Phone
- (770) 996-6588
- Mailing Fax
- (770) 997-8240
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-04-2007
- Last Update Date
- 08-26-2016
- Code Navigator
Location Map
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.
- 060-01-256-2
- 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.
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 |
|---|---|---|---|
| 112615323A | MEDICAID (05) | GA |
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Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639377385, enumerated as an "organization" on July 04, 2007.
The provider is located at 2650 COLONIAL DR COLLEGE PARK, GA 30337 and the phone number is (404) 209-9296.
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.
