CHRIS 180, INC. (NPI# 1134257827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134257827 |
| Entity Type | Organization |
| Organization Name | CHRIS 180, INC. |
| Other Organization Name | CHRIS |
| Practice Address |
1017 Fayetteville Road Suite A Atlanta GA 30316-2936 |
| Practice Telephone | 4043244190 |
| Practice Fax Number | 4043244191 |
| Mailing Telephone | 4043244190 |
| Mailing Fax Number | 4043244091 |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2019-03-30 |
| Authorized Official Name | MR. DAN JAMES BELLOR (CLINIC ADMINISTRATOR) |
| Authorized Official Telephone | 4044869034 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 640804505L | 05 | |
| GA | 640804505E | 05 | |
| GA | 640804505M | 05 | |
| GA | 300023628A | 05 |
| Other Name | Type Code |
|---|---|
| Chris | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3700 Martin Luther King Jr Dr Sw, Atlanta, GA 303313674 | 4044869034 | 4048359350 |
| 7741 Roswell Rd Ste B, Atlanta, GA 303504845 | 4044869035 | 4048539350 |
| 2805 Metropolitan Pkwy Sw, Atlanta, GA 303157915 | 4044869034 | 4048359350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003377086 | Chris 180, Inc. | Community/Behavioral Health | 3700 Martin Luther King Dr Sw, Atlanta, GA 30331-3674 | 2019-03-30 |
| 1205397247 | Chris 180, Inc. | Community/Behavioral Health | 740 Cameron M Alexander Blvd Nw, Atlanta, GA 30318-6812 | 2019-03-30 |
| 1295296234 | Chris 180, Inc. | Community/Behavioral Health | 7741 Roswell Rd Ste B, Atlanta, GA 30350-4845 | 2019-03-30 |
| 1770044810 | Chris 180, Inc. | Community/Behavioral Health | 2805 Metropolitan Pkwy Sw, Atlanta, GA 30315-7915 | 2019-03-30 |
| Street Address |
1017 FAYETTEVILLE ROAD SUITE A |
| City | ATLANTA |
| State | GA |
| Zip Code | 30316-2936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861040941 | N'daisha Carrington | Counselor | 1017 Fayetteville Road, Atlanta, GA 30331 | 2019-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156923 | Rakiya Williams | Counselor | 1030 Fayetteville Rd., Atlanta, GA 30316 | 2019-10-23 |
| 1215585815 | Madison Victoria Baugh | Counselor | Chris180, 1030 Fayetteville Rd, Atlanta, GA 30316 | 2019-08-28 |
| 1265089460 | Josee Dominque Muldrew | Counselor | 1030 Fayetteville Rd. Se, Atlanta, GA 30316 | 2019-08-22 |
| 1255984241 | Monique Overstreet | Counselor | 1030 Fayetteville Road, Atlanta, GA 30316 | 2019-07-19 |
| 1023573979 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 905 Memorial Drive Se, Atlanta-fulton, GA 30316 | 2019-02-05 |
| 1740726454 | Jimmy Brian Sambula | Behavior Technician | 1017 Fayetteville Rd. Se, Atlanta, GA 30316 | 2017-01-19 |
| 1033665039 | Liberty Group Senior Services | Clinic/Center | 1879 Glenwood Avenue, Atlanta, GA 30316 | 2016-08-30 |
| 1043673650 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 800 Glenwood Ave Se, Atlanta, GA 30316 | 2016-03-31 |
| 1992143382 | Ayodele Osasona | Surgery | 2004 Oak Terrace Dr Se, Atlanta, GA 30316 | 2013-06-07 |
| 1891945721 | Denise Renee Cagle | Social Worker | 1471 Town Country Dr Se, Atlanta, GA 30316 | 2008-09-28 |
| Find all providers in zip 30316 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1700427820 | Trust2change, LLC. | Community/Behavioral Health | 2900 Chamblee Tucker Rd Bldg 8, Atlanta, GA 30341-4100 | 2019-09-30 |
| 1538712088 | Ferris Healthcare Group | Community/Behavioral Health | 2900 Paces Ferry Rd Se Bldg C, Atlanta, GA 30339-5702 | 2019-07-23 |
| 1245890987 | Soc Integrated Services, LLC | Community/Behavioral Health | 130 Wynfield Way Sw, Atlanta, GA 30331-6837 | 2019-06-15 |
| 1770046740 | Z-one Incorporated | Community/Behavioral Health | 505 Tufton Trl Se, Atlanta, GA 30354-2867 | 2019-04-08 |
| 1003377086 | Chris 180, Inc. | Community/Behavioral Health | 3700 Martin Luther King Dr Sw, Atlanta, GA 30331-3674 | 2019-03-30 |
| 1144790783 | Danielle Smith | Community/Behavioral Health | 880 Glenwood Ave Se Unit 3185, Atlanta, GA 30316-1955 | 2018-11-27 |
| 1073083762 | Michael Pollock | Community/Behavioral Health | 3725 Princeton Lakes Pkwy Sw Apt 7003, Atlanta, GA 30331-5560 | 2018-11-26 |
| 1851881353 | Atlanta Life Journeys Services, LLC | Community/Behavioral Health | 3196 Dogwood Dr, Atlanta, GA 30354-1149 | 2018-05-10 |
| Find all providers in ATLANTA | ||||
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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.