363L00000X
Nursing Facility/Intermediate Care Facility in Atlanta, Georgia
1760856645- Practice location
- 2171 Peachtree RD NE, Apt 306, Atlanta, GA 30309-6300
- Phone
- 678-464-9424
- Fax
- —
- Last updated
- November 16, 2015
363L00000X is a healthcare organization based in Atlanta, GA. The NPI number for 363L00000X is 1760856645 and holds license No. 363L00000X (GA). The current practice location address is 2171 Peachtree RD NE, Apt 306, Atlanta, GA 30309-6300 and the office can be reached by phone at 678-464-9424. The NPI was assigned on November 16, 2015 and the record was last updated in NPPES on November 16, 2015.
●Provider Profile Details
- NPI Number
- 1760856645
- Provider Name
- 363L00000X
- Entity Type
- Organization (Type 2 NPI)
- Primary Taxonomy
- Nursing Facility/Intermediate Care Facility · 313M00000X
- Organization Subpart
- No
- Authorized Official
- Mrs. Anetha Deborah Peterson · Nurse Practitioner · 678-464-9424
- Enumeration Date
- November 16, 2015
- Last Update Date
- November 16, 2015
- NPI Status
- Active
◉Business Practice Location Address
- Address
- 2171 Peachtree RD NE
Apt 306
Atlanta, GA 30309-6300 - City
- Atlanta
- State
- Georgia
- ZIP
- 30309-6300
- Country
- US
- Phone Number
- 678-464-9424
✉Business Mailing Address
- Address
- 2171 Peachtree RD NE
Apt 306
Atlanta, GA 30309-6300 - City
- Atlanta
- State
- GA
- ZIP
- 30309-6300
- Phone Number
- 678-464-9424
✎Taxonomy & License Information
| Taxonomy | Code | Primary | License | State |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | Yes | 363L00000X | GA |
#Other Provider Identifiers
No legacy or other identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.
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View all providers in Atlanta →?Frequently Asked Questions
What is the NPI number of 363L00000X?
The NPI number of 363L00000X is 1760856645. It was assigned on November 16, 2015 and is currently active in the NPPES registry.
What is the specialty of 363L00000X?
363L00000X is registered under the primary taxonomy Nursing Facility/Intermediate Care Facility (code 313M00000X) and holds license No. 363L00000X (GA).
Where does 363L00000X practice?
The practice location is 2171 Peachtree RD NE, Apt 306, Atlanta, GA 30309-6300. The office can be reached at 678-464-9424 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1760856645 directly on the NPPES registry website at npiregistry.cms.hhs.gov.