NONE
NPI 1760609895
Intermediate Care Facility, Mental Illness in Decatur, GA

Q: What is Cassandra Gilliam's NPI number?

The NPI number for Cassandra Gilliam is 1760609895. It was assigned to this organization in the NPPES registry on April 19, 2007.

Q: What is Cassandra Gilliam's specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Mental Illness with taxonomy code 310500000X.

Q: When was this NPI record last updated?

The NPPES record for Cassandra Gilliam was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since April 19, 2007

450 WINN WAY, DECATUR, GA 30030(404) 294-0499 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About None NPPES

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

NONE (NPI 1760609895) is a healthcare organization registered as an intermediate care facility, mental illness in Decatur, Georgia and active in the NPI registry since April 2007. The organization lists Cassandra Shea Gilliam, Rn, as its authorized official.

NPPES Registry Identity

NPI1760609895

Entity TypeOrganization

Primary Taxonomy310500000X

Legal Business NameCASSANDRA GILLIAM

Location Address450 WINN WAYDecatur, GA 30030-1715

Mailing Address3850 Eden Glen Dr SeConyers, GA 30013-5813 · (770) 679-4366

Phone(404) 294-0499

Organization SubpartNo

Authorized OfficialCassandra Shea GilliamRn · (404) 294-0499

Enumeration DateApril 19, 2007

Last NPPES UpdateAugust 22, 2020

✔ NPI 1760609895 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Mental IllnessNursing & Custodial Care Facilities

Taxonomy Code310500000X

License✔ Licensed in GA · RN171251

Definition

A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness.

450 WINN WAY, Decatur, GA 30030

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. BRENDA KAY CIBULAS APRN, BC, CGP

Clinical Nurse Specialist (Psychiatric/Mental Health)