ANDREA STREETER (NPI# 1205205473) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205205473 |
Entity Type | Individual |
Full Name | ANDREA STREETER |
Practice Address |
439 Watson Bay Stone Mountain GA 30087-6195 |
Practice Telephone | 7704656858 |
Mailing Telephone | 7704656858 |
Enumeration Date | 2015-09-17 |
Last Update Date | 2015-09-17 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 044016471 | GA | Nursing & Custodial Care Facilities |
Street Address |
439 WATSON BAY |
City | STONE MOUNTAIN |
State | GA |
Zip Code | 30087-6195 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225358856 | 'a' Helping Hand, Inc. | Intermediate Care Facility, Mentally Retarded | 439 Watson Bay, Stone Mountain, GA 30087-6195 | 2010-06-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477176394 | Optimal Choice Telehealth | General Practice | 1227 Rockbidge Rd Sw, Ste 208-354, Stone Mountain, GA 30087 | 2020-05-27 |
1245882943 | Lynell Williams | Counselor | 505 Lilburn-stone Mountain Road, Suite 235, Stone Mountain, GA 30087 | 2019-07-12 |
1003302688 | Mark Andrew Stevens | Physical Therapist | 1227 Rockbridge Rd Ste 402, Stone Mountain, GA 30087 | 2018-07-06 |
1154816825 | Tuan Minh Khong | Physician Assistant | 6301 Southland Rdg, Stone Mountain, GA 30087 | 2018-06-26 |
1215429881 | Stephanie Martin | Nurse Practitioner | 2720 S Rockbridge Rd, Stone Mountain, GA 30087 | 2018-05-30 |
1578979381 | Edmund Thomas Jr. | Dentist | 2536 Rockbridge Rd Ste 103, Stone Mountain, GA 30087 | 2014-07-02 |
1790027688 | Robert Fanning Eaves Jr. | General Practice | 5394 Leatherstocking Lane, Stone Mountain, GA 30087 | 2013-03-19 |
1609128917 | Mary Marlene Muse | Lactation Consultant, Non-RN | 510 Navarre Drive, Stone Mountain, GA 30087 | 2012-10-10 |
1457680704 | Cleo Evans | Counselor | 5638 Manassas Run, Stone Mountain, GA 30087 | 2009-12-16 |
1932348521 | Lawrence Randy Sheber | Dentist | 5500-a Lilburn Stone Mountain Road, Stone Mountain, GA 30087 | 2009-02-05 |
Find all providers in zip 30087 |
Taxonomy Code | 315P00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Intermediate Care Facility, Mentally Retarded |
(1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225358856 | 'a' Helping Hand, Inc. | Intermediate Care Facility, Mentally Retarded | 439 Watson Bay, Stone Mountain, GA 30087-6195 | 2010-06-05 |
1427378058 | Precious Living Incorporated | Intermediate Care Facility, Mentally Retarded | 448 Registry Blf, Stone Mountain, GA 30087-6602 | 2010-06-05 |
1275863383 | Bryana Personal Care Home | Intermediate Care Facility, Mentally Retarded | 6276 Field Glen Rd, Stone Mountain, GA 30087-4911 | 2010-01-12 |
1740404037 | Butler-bowden Personal Care Home, Inc | Intermediate Care Facility, Mentally Retarded | 694 Leighton Way, Stone Mountain, GA 30088-1829 | 2007-04-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326586744 | Hand-n-hand PCh Inc. | Intermediate Care Facility, Mentally Retarded | 125 Janette Ln, Moultrie, GA 31788-7837 | 2017-02-06 |
1902232598 | Enable of Georgia, Inc. | Intermediate Care Facility, Mentally Retarded | 1200 Old Ellis Rd, Roswell, GA 30076-3850 | 2013-09-16 |
1326392432 | Extending Community Services Foundation | Intermediate Care Facility, Mentally Retarded | 3630 Emerald Pt, Decatur, GA 30034-5739 | 2012-10-29 |
1639441421 | Smith Personal Care Home 1and 2 Inc | Intermediate Care Facility, Mentally Retarded | 309 Advance St, Swainsboro, GA 30401-3675 | 2012-02-08 |
1609146109 | Rainbow Ridge#2,inc. | Intermediate Care Facility, Mentally Retarded | 181 Rainbow Rdg, Swainsboro, GA 30401-4413 | 2011-12-31 |
1427336346 | Tranquility PCh, LLC | Intermediate Care Facility, Mentally Retarded | 3440 Rainbow Dr, Decatur, GA 30034-1807 | 2011-07-26 |
1720318843 | Allgood Manor Assistant Home Inc. | Intermediate Care Facility, Mentally Retarded | 6358 Deshong Dr, Lithonia, GA 30058-6123 | 2010-01-12 |
1053540260 | Nue Beginnings Residence Home Inc | Intermediate Care Facility, Mentally Retarded | 5183 Suggs St, Powder Springs, GA 30127-3029 | 2009-07-09 |
1033236088 | Nicekare Inc | Intermediate Care Facility, Mentally Retarded | 1210b E De Renne Ave, Savannah, GA 31406-2016 | 2007-03-23 |
1215072038 | Open Arms Care Corporation | Intermediate Care Facility, Mentally Retarded | 6715 Highway 41, Ringgold, GA 30736-2643 | 2007-02-20 |
Find all providers with the same taxonomy |
City | STONE MOUNTAIN |
Zip Code | 30087 |
Please comment or provide details below to improve the information on ANDREA STREETER.
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.