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363L00000X
NPI 1760856645
Nursing Facility/Intermediate Care Facility in Atlanta, GA

Active since November 16, 2015
2171 PEACHTREE RD NE, APT 306, ATLANTA, GA 30309(678) 464-9424 Get Directions Write a Review

NPPES record last updated: November 16, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About 363l00000x NPPES

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

363L00000X (NPI 1760856645) is a healthcare organization registered as a nursing facility/intermediate care facility in Atlanta, Georgia and active in the NPI registry since November 2015. The organization lists Anetha Deborah Peterson, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1760856645
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business Name363L00000X
Location Address2171 PEACHTREE RD NE, APT 306Atlanta, GA 30309-6300
Mailing Address2171 Peachtree Rd Ne, Apt 306Atlanta, GA 30309-6300 · (678) 464-9424
Phone(678) 464-9424
Organization SubpartNo
Authorized OfficialAnetha Deborah PetersonNurse Practitioner · (678) 464-9424
Enumeration DateNovember 16, 2015
✔ NPI 1760856645 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in GA · 363L00000X
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
2171 PEACHTREE RD NE, Atlanta, GA 30309
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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 363l00000x's NPI number?

The NPI number for 363l00000x is 1760856645. It was assigned to this organization in the NPPES registry on November 16, 2015.

Where is 363l00000x located?

363l00000x is located at 2171 Peachtree Rd NE Apt 306, Atlanta, GA 30309. The listed phone number is (678) 464-9424.

What is 363l00000x's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

When was this NPI record last updated?

The NPPES record for 363l00000x was last updated on November 16, 2015. 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.