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MAGNOLIA GARDENS PCH, INC
NPI 1912138454
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Stone Mountain, GA

Active since July 31, 2009
5348 KELLEYS CREEK DR, STONE MOUNTAIN, GA 30088(770) 469-8925(770) 469-8925 Get Directions Write a Review

NPPES record last updated: March 12, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Magnolia Gardens Pch, Inc NPPES

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

MAGNOLIA GARDENS PCH, INC (NPI 1912138454) is a healthcare organization registered as a community based residential treatment facility, intellectual and/or developmental disabilities in Stone Mountain, Georgia and active in the NPI registry since July 2009. The organization lists Teri D. Cargill, Director, as its authorized official.

NPPES Registry Identity

NPI1912138454
Entity TypeOrganization
Primary Taxonomy320900000X
Legal Business NameMAGNOLIA GARDENS PCH, INC
Location Address5348 KELLEYS CREEK DRStone Mountain, GA 30088-3827
Mailing AddressPo Box 684Lovejoy, GA 30250-0684 · (770) 469-8925 · Fax (770) 469-8925
Phone(770) 469-8925
Fax(770) 469-8925
Organization SubpartNo
Authorized OfficialTeri D. CargillDirector · (678) 697-0575
Enumeration DateJuly 31, 2009
Last NPPES UpdateMarch 12, 2010
✔ NPI 1912138454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
5348 KELLEYS CREEK DR, Stone Mountain, GA 30088
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Other Identifiers 1

Medicaid256949895BGA

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 Magnolia Gardens Pch, Inc's NPI number?

The NPI number for Magnolia Gardens Pch, Inc is 1912138454. It was assigned to this organization in the NPPES registry on July 31, 2009.

Where is Magnolia Gardens Pch, Inc located?

Magnolia Gardens Pch, Inc is located at 5348 Kelleys Creek Dr, Stone Mountain, GA 30088. The listed phone number is (770) 469-8925.

What is Magnolia Gardens Pch, Inc'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 Magnolia Gardens Pch, Inc was last updated on March 12, 2010. 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.