CASSANDRA GILLIAM (NPI# 1760609895) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760609895 |
| Entity Type | Organization |
| Organization Name | CASSANDRA GILLIAM |
| Other Organization Name | NONE |
| Practice Address |
450 Winn Way Decatur GA 30030-1715 |
| Mailing Address |
3850 Eden Glen Dr Se Conyers GA 30013-5813 |
| Practice Telephone | 4042940499 |
| Mailing Telephone | 7706794366 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. CASSANDRA SHEA GILLIAM (RN) |
| Authorized Official Telephone | 4042940499 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310500000X | Intermediate Care Facility, Mental Illness | RN171251 | GA | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| none | Other Name - Individual/Organization |
| Street Address |
450 WINN WAY |
| City | DECATUR |
| State | GA |
| Zip Code | 30030-1715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922142108 | Dekalb Community Service Board | Community/Behavioral Health | 450 Winn Way, Decatur, GA 30030-1715 | 2007-02-19 |
| 1386130078 | James Cabble | Social Worker | 450 Winn Way, Decatur, GA 30030-1715 | 2018-07-05 |
| 1033621453 | Jennifer Young | Counselor | 450 Winn Way, Decatur, GA 30030-1715 | 2017-10-25 |
| 1528426178 | Jessica Brown | Counselor | 450 Winn Way, Decatur, GA 30030-1715 | 2016-02-10 |
| 1508106873 | Sabo Uba | Clinical Nurse Specialist | 450 Winn Way, Decatur, GA 30030-1715 | 2013-02-25 |
| 1174800072 | Shashank Kumar Jha | Nurse Practitioner | 450 Winn Way, Decatur, GA 30030-1715 | 2011-11-07 |
| 1720212616 | Nancy A Ruffin | Registered Nurse | 450 Winn Way, Decatur, GA 30030-1715 | 2009-05-07 |
| 1952544041 | Helenie Keyamo Davis | Registered Nurse | 450 Winn Way, Decatur, GA 30030-1715 | 2009-04-20 |
| 1316185374 | Lorraine D Corley | Social Worker | 450 Winn Way, Decatur, GA 30030-1715 | 2009-01-29 |
| 1346411899 | Sara R Grimsley | Pharmacist | 450 Winn Way, Decatur, GA 30030-1715 | 2008-03-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
| 1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
| Find all providers in zip 30030 | ||||
| Taxonomy Code | 310500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mental Illness |
| A nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023453990 | Transitions Services LLC | Intermediate Care Facility, Mental Illness | 3277 Casa Linda Dr, Decatur, GA 30032-7151 | 2013-05-06 |
| 1134126063 | Decatur Manor Healthcare, LLC | Intermediate Care Facility, Mental Illness | 1016 W Pershing Rd, Decatur, IL 62526-1541 | 2005-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861861361 | Child, Youth, Adolescents, and Families | Intermediate Care Facility, Mental Illness | 1396 Southlake Plaza Dr, Morrow, GA 30260-1756 | 2015-09-15 |
| 1801230586 | South Horizon Healthcare LLC | Intermediate Care Facility, Mental Illness | 4030 North Henry Blv., Suite 201, Stockbridge, GA 30281 | 2013-04-24 |
| 1073626347 | Georgia Dept of Human Resources | Intermediate Care Facility, Mental Illness | 189 Boone Cir, Milledgeville, GA 31062-7525 | 2006-08-17 |
| 1346238276 | James B. Craig Center | Intermediate Care Facility, Mental Illness | 200 Allen Rd, Milledgeville, GA 31062-7523 | 2005-10-13 |
| 1871978965 | Lookout Mountain Community Services | Intermediate Care Facility, Mental Illness | 1875 Fant Dr, Fort Oglethorpe, GA 30742-3307 | 2015-07-30 |
| 1467700732 | Pathways Hopes Corner | Intermediate Care Facility, Mental Illness | 756 Woodbury Hwy, Greenville, GA 30222-1514 | 2012-08-17 |
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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.