KEENAN JAMES PACUT (NPI# 1013540160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013540160 |
| Entity Type | Individual |
| Full Name | KEENAN JAMES PACUT |
| Practice Address |
410 E Church St Fort Valley GA 31030-3097 |
| Practice Telephone | 2299387274 |
| Mailing Telephone | 2299387274 |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2020-02-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Street Address |
410 E CHURCH ST |
| City | FORT VALLEY |
| State | GA |
| Zip Code | 31030-3097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366521932 | Middle Flint Area Community Service Board | Community/Behavioral Health | 410 E Church St, Fort Valley, GA 31030-3097 | 2006-11-03 |
| 1568094449 | Emanuel Malik Anderson | Community/Behavioral Health | 410 E Church St, Fort Valley, GA 31030-3097 | 2020-02-07 |
| 1790328649 | Kali Mccalvin | Community Health Worker | 410 E Church St, Fort Valley, GA 31030-3097 | 2019-10-23 |
| 1508334988 | Cassandra Robinson | Case Manager/Care Coordinator | 410 E Church St, Fort Valley, GA 31030-3097 | 2018-11-05 |
| 1285123885 | Alisa Oates | Licensed Practical Nurse | 410 E Church St, Fort Valley, GA 31030-3097 | 2018-05-09 |
| 1457890048 | Frederick Mclaughlin Sr. | Social Worker | 410 E Church St, Fort Valley, GA 31030-3097 | 2017-02-16 |
| 1902345440 | Shavon Mcwilliams | Social Worker | 410 E Church St, Fort Valley, GA 31030-3097 | 2017-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801302997 | Careconnect Health, Inc. | Clinic/Center | 209 North Camellia Blvd., Fort Valley, GA 31030 | 2017-12-27 |
| 1902345408 | Latrina Avant | Counselor | 164 Mahoney Lane, Fort Valley, GA 31030 | 2017-02-16 |
| 1447648159 | Five Points Pharmacy, LLC | Pharmacy | 115 Commercial Heights, Fort Valley, GA 31030 | 2015-01-05 |
| 1316208341 | Ulysses L. Marable IIi, Dmd, LLC | Dentist | 1030 Peach Parkway, Ste 9, Fort Valley, GA 31030 | 2012-06-06 |
| 1083901706 | Church Home Rehabilitation and Healthcare, LLC | Skilled Nursing Facility | 2470 Hwy 41 North, Fort Valley, GA 31030 | 2011-07-01 |
| 1295054393 | Melanie Marie Henson | Counselor | 410 East Church Street, Fort Valley, GA 31030 | 2010-05-28 |
| 1538329016 | First Born Outreach Center Inc | Assisted Living Facility | 103 Lavender Street, Fort Valley, GA 31030 | 2008-06-10 |
| 1871507640 | Gayton Health Centre | Optometrist | 440 Taylors Mill Rd, Fort Valley, GA 31030 | 2006-07-28 |
| 1215906136 | Renal Treatment Centers Mid Atlantic Inc | Clinic/Center | 557 Bluebird Blvd, Fort Valley, GA 31030 | 2006-03-14 |
| 1871568550 | Patricia S Winter | Counselor | 700 Mlk Dr, Ft Valley, GA 31030 | 2006-02-17 |
| Find all providers in zip 31030 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114253416 | The Regeneration Project | Community/Behavioral Health | 378 Tabor Rd, Fort Valley, GA 31030-6024 | 2009-10-22 |
| 1366521932 | Middle Flint Area Community Service Board | Community/Behavioral Health | 410 E Church St, Fort Valley, GA 31030-3097 | 2006-11-03 |
| 1568094449 | Emanuel Malik Anderson | Community/Behavioral Health | 410 E Church St, Fort Valley, GA 31030-3097 | 2020-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699376160 | Love, Breanna Olivia Zion Enterprise,llc(lboz): | Community/Behavioral Health | 9802 N Ivy Park Dr, Fortson, GA 31808-7130 | 2020-11-02 |
| 1578170882 | Helping Hearts Behavioral Health Services, LLC | Community/Behavioral Health | 504 Hamlet Dr, Hampton, GA 30228-4829 | 2020-09-30 |
| 1982219523 | Future Seekers, Inc. | Community/Behavioral Health | 3475 N. Desert Drive, Building 1, Suite 2100, East Point, GA 30344-3034 | 2020-09-10 |
| 1396359840 | Just Like Family Caregivers | Community/Behavioral Health | 2628 Lovejoy Crossing St, Hampton, GA 30228-5995 | 2020-09-02 |
| 1285247270 | Hudu Yoga & Therapy | Community/Behavioral Health | 3900 Springleaf Ct, Stone Mountain, GA 30083-4692 | 2020-08-28 |
| 1952914632 | Brighter Dayz, Incorporated | Community/Behavioral Health | 1016 Howell Mill Rd Nw Apt 4408, Atlanta, GA 30318-5592 | 2020-08-24 |
| 1699387688 | Rise Rehabilitation Services, LLC | Community/Behavioral Health | 738 Highland Park Trl, Atlanta, GA 30350-6706 | 2020-08-20 |
| 1104438373 | Pivotal Counseling LLC | Community/Behavioral Health | 75 N Broad St, Winder, GA 30680-1907 | 2020-08-19 |
| 1295347888 | Freemans Early Intervention Services | Community/Behavioral Health | 13 Peach St, Butler, GA 31006 | 2020-08-17 |
| 1861017634 | Trinity Care Counseling | Community/Behavioral Health | 3475 Northwinds Parkway, 200, Alpharetta, GA 30009 | 2020-06-08 |
| Find all providers with the same taxonomy | ||||
| City | FORT VALLEY |
| Zip Code | 31030 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.