BIG MAMA HOUSE


Address: 707 Pennybrook Ln, Stone Mountain, GA 30087-5918
Phone: 4045386074

BIG MAMA HOUSE (NPI# 1659752491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1659752491
Entity Type Organization
Organization Name BIG MAMA HOUSE
Practice Address 707 Pennybrook Ln
Stone Mountain
GA 30087-5918
Practice Telephone 4045386074
Mailing Telephone 4045386074
Enumeration Date 2015-06-17
Last Update Date 2015-06-17
Authorized Official Name HANNIYAH ABDUL AZIZ (CEO/OWNER)
Authorized Official Telephone 4045386074
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 101YM0800X Counselor
Specialization: Mental Health 		Behavioral Health & Social Service Providers
Y 320900000X Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities Residential Treatment Facilities

Office Location

Street Address 707 PENNYBROOK LN
City STONE MOUNTAIN
State GA
Zip Code 30087-5918

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
Notes: [7/1/2003: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1699157198 Love With Compassion Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1093 Forest Path, Stone Mountain, GA 30088-2923 2015-06-22
1255777074 Wright Horizon Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 482 Stonewood Dr, Stone Mountain, GA 30087-5649 2013-05-20
1972872695 Universal Homecare Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1292 Adcox Sq, Stone Mountain, GA 30088-4546 2011-12-27
1932401403 Annointed Handsl Lll Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 460 N Hairston Rd, Stone Mountain, GA 30083-4335 2010-12-03
1184801607 Brightstar Homes and Services Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 5135 Golfbrook Ct, Stone Mountain, GA 30088-3117 2008-01-28
1760666143 Bj&w Personal Care Home Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 951 Pine Roc Dr, Stone Mountain, GA 30083-3523 2007-12-21
1699156216 Faith Dwellings, Inc. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 4666 Randalwood Dr, Stone Mountain, GA 30083-4350 2015-06-10

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1790385862 Hickory Log Vocational School Inc Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 3680 Highway 411 Ne, White, GA 30184-2427 2020-10-28
1801403050 Safe Haven Personal Care Home Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 10875 Abercorn St Apt 132, Savannah, GA 31419-1843 2020-09-30
1659987931 Pinkies Place Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 216 Self St, Warner Robins, GA 31088-5506 2020-09-22
1629680293 Caregiver Ga, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 3736 Executive Center Dr Ste B, Augusta, GA 30907-2360 2020-08-17
1730799073 Victory Won Counseling and Res Care Prof. Corp Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 5014 Snapfinger Woods Dr, Decatur, GA 30035-4003 2020-08-02
1811528649 Unison Behavioral Health Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 211 North Street, Douglas, GA 31533 2020-01-30
1619519709 Gateway Behavioral Health Services Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 516 Freedom Trl, Brunswick, GA 31525-4712 2019-10-10
1215581756 Elegant Lm Management, LLC Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1020 Meadowsong Circle, Lawrenceville, GA 30043 2019-08-01
1467013821 Csb of East Central Ga Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 5101 Parnell Way, Martinez, GA 30907-8896 2019-06-26
1013474915 Community Service Board of East Central Georgia Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 1715 Lawerence Rd, Hephzibah, GA 30815-4445 2019-02-27
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Competitor

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City STONE MOUNTAIN
Zip Code 30087

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Dataset Information

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.

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