DEKALB COMMUNITY SERVICE BOARD (NPI# 1154466142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154466142 |
| Entity Type | Organization |
| Organization Name | DEKALB COMMUNITY SERVICE BOARD |
| Other Organization Name | EMBRY CIRCLE GROUP HOME |
| Practice Address |
3571 Embry Cir Chamblee GA 30341-5613 |
| Mailing Address |
445 Winn Way Fl 4 Decatur GA 30030-1707 |
| Practice Telephone | 7709868746 |
| Practice Fax Number | 7709868746 |
| Mailing Telephone | 4042943836 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-04-23 |
| Authorized Official Name | FABIO BRUNO VAN DER MERWE (COO) |
| Authorized Official Telephone | 4042943836 |
| Is Organization Subpart | Y |
| Parent Organization Name | DEKALB COMMUNITY SERVICE BOARD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | Agencies |
| Other Name | Type Code |
|---|---|
| Embry Circle Group Home | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750426755 | Dekalb Community Service Board | Community/Behavioral Health | 2129 Luray Ct, Dunwoody, GA 30338-5212 | 2007-02-20 |
| 1548304637 | Dekalb Community Service Board | Community/Behavioral Health | 4781 Lewis Rd, Stone Mountain, GA 30083-1020 | 2007-02-20 |
| 1932244993 | Dekalb Community Service Board | Community/Behavioral Health | 1116 Alford Rd, Lithonia, GA 30058-6094 | 2007-02-20 |
| 1629113436 | Dekalb Community Service Board | Community/Behavioral Health | 4559 Lavista Rd, Tucker, GA 30084-4225 | 2007-02-20 |
| 1497890214 | Dekalb Community Service Board | Community/Behavioral Health | 4200 Waterloo Cir, Tucker, GA 30084-2237 | 2007-02-20 |
| 1861536955 | Dekalb Community Service Board | Community/Behavioral Health | 2660 Osborne Rd Ne, Atlanta, GA 30319-2832 | 2007-02-20 |
| 1003951088 | Dekalb Community Service Board | Community/Behavioral Health | 4316 Smithsonia Dr, Tucker, GA 30084-2615 | 2007-02-20 |
| 1427193226 | Dekalb Community Service Board | Community/Behavioral Health | 1536 Saint Dunstans Rd, Lithonia, GA 30058-5632 | 2007-02-20 |
| 1528103512 | Dekalb Community Service Board | Community/Behavioral Health | 3807 Clairmont Road Ne, Chamblee, GA 30341 | 2007-02-20 |
| 1740324805 | Dekalb Community Service Board | Community/Behavioral Health | 3100 Clifton Springs Rd, Decatur, GA 30034-4606 | 2007-02-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DEKALB COMMUNITY SERVICE BOARD | 445 Winn Way, Decatur, GA 30030-1707 |
| Street Address |
3571 EMBRY CIR |
| City | CHAMBLEE |
| State | GA |
| Zip Code | 30341-5613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992207344 | Rabun Marie Robertson | Occupational Therapist | 2320 Perimeter Park Drive, Atlanta, GA 30341 | 2018-03-01 |
| 1568986313 | Charles Edge IIi | Nurse Practitioner | 4770 Buford Highway, Atlanta, GA 30341 | 2017-08-02 |
| 1366971277 | Park Ridge Healthcare and Physical Medicine LLC | Nurse Practitioner | 2896 Chamblee Tucker Road, Suite 4, Atlanta, GA 30341 | 2017-06-06 |
| 1437502937 | Chara Mcgill | Counselor | 13207 Jefferson Circle N, Chamblee, GA 30341 | 2016-07-20 |
| 1982063913 | Stepping Stone of Atlanta | Community/Behavioral Health | 3705 Chamblee Dunwoody Rd, Chamblee, GA 30341 | 2016-02-18 |
| 1013317577 | Marne Day | Counselor | 3720 Chamblee Dunwoody Rd, Chamblee, GA 30341 | 2014-09-02 |
| 1013343680 | Keelan Walker | Speech-Language Pathologist | 4961 Buford Highway Suite 201, Suite 201, Chamblee, GA 30341 | 2013-09-16 |
| 1578901955 | Promonitor LLC | Electrodiagnostic Medicine | 3300 Northwest Expy Bldg 7, Atlanta, GA 30341 | 2013-06-07 |
| 1639415359 | Lawanda B Cooke | Health Educator | 5280 Peachtree Ind Blvd, Chamblee, GA 30341 | 2012-12-28 |
| 1457602773 | Arthur Macrae Wendel | Family Medicine | 4770 Buford Hwy Ms F60, Atlanta, GA 30341 | 2012-09-26 |
| Find all providers in zip 30341 | ||||
| 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 |
|---|---|---|---|---|
| 1982063913 | Stepping Stone of Atlanta | Community/Behavioral Health | 3705 Chamblee Dunwoody Rd, Chamblee, GA 30341 | 2016-02-18 |
| 1528103512 | Dekalb Community Service Board | Community/Behavioral Health | 3807 Clairmont Road Ne, Chamblee, GA 30341 | 2007-02-20 |
| 1497890461 | Chamblee - Dunwoody Group Home | Community/Behavioral Health | 4235 Chamblee Dunwoody Rd, Chamblee, GA 30341-1426 | 2007-02-20 |
| 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 | ||||
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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.