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NEW DOMUS PERSONAL CARE, LLC
NPI 1639377385
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in College Park, GA

Active since July 04, 2007
2650 COLONIAL DR, COLLEGE PARK, GA 30337(404) 209-9296 Get Directions Write a Review

NPPES record last updated: August 26, 2016. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About New Domus Personal Care, Llc NPPES

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

NEW DOMUS PERSONAL CARE, LLC (NPI 1639377385) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in College Park, Georgia and active in the NPI registry since July 2007. The organization lists Jackie Othella Smith, Ceo, as its authorized official.

NPPES Registry Identity

NPI1639377385
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameNEW DOMUS PERSONAL CARE, LLC
Location Address2650 COLONIAL DRCollege Park, GA 30337-4923
Mailing Address6229 Johnson RdRiverdale, GA 30274-1806 · (770) 996-6588 · Fax (770) 997-8240
Phone(404) 209-9296
Organization SubpartNo
Authorized OfficialJackie Othella SmithCeo · (770) 996-6588
Enumeration DateJuly 4, 2007
Last NPPES UpdateAugust 26, 2016
✔ NPI 1639377385 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 · 060-01-256-2
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
2650 COLONIAL DR, College Park, GA 30337
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Other Identifiers 1

Medicaid112615323AGA

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 New Domus Personal Care, LLC's NPI number?

The NPI number for New Domus Personal Care, LLC is 1639377385. It was assigned to this organization in the NPPES registry on July 4, 2007.

Where is New Domus Personal Care, LLC located?

New Domus Personal Care, LLC is located at 2650 Colonial Dr, College Park, GA 30337. The listed phone number is (404) 209-9296.

What is New Domus Personal Care, LLC'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 New Domus Personal Care, LLC was last updated on August 26, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.