CHILD, YOUTH, ADOLESCENTS, AND FAMILIES (NPI# 1861861361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861861361 |
| Entity Type | Organization |
| Organization Name | CHILD, YOUTH, ADOLESCENTS, AND FAMILIES |
| Practice Address |
1396 Southlake Plaza Dr Morrow GA 30260-1756 |
| Practice Telephone | 7704732640 |
| Practice Fax Number | 7704732601 |
| Mailing Telephone | 7704732640 |
| Mailing Fax Number | 7704732601 |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |
| Authorized Official Name | MS. ELANTA THOMAS (REGISTERED NURSE) |
| Authorized Official Telephone | 7704782640 |
| Authorized Official Credential | REGISTERED NURSE |
| Is Organization Subpart | Y |
| Parent Organization Name | BEHAVIORAL HEALTH DERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310500000X | Intermediate Care Facility, Mental Illness | RN228517 | GA | Nursing & Custodial Care Facilities |
| Street Address |
1396 SOUTHLAKE PLAZA DR |
| City | MORROW |
| State | GA |
| Zip Code | 30260-1756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073152294 | Nichelle J Reefer | Counselor | 1396 Southlake Plaza Dr, Morrow, GA 30260-1756 | 2020-01-06 |
| 1215583596 | Xylina Jenkins | Counselor | 1396 Southlake Plaza Dr, Morrow, GA 30260-1756 | 2019-08-13 |
| 1679015960 | Elanta Thomas | Registered Nurse | 1396 Southlake Plaza Dr, Morrow, GA 30260-1756 | 2016-11-17 |
| 1639621931 | Marlo Demetra Mathis | Counselor | 1396 Southlake Plaza Dr, Morrow, GA 30260-1756 | 2016-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538766605 | C. Alexander Pediatrics LLC | Emergency Medicine | 2180 Rex Road, Morrow, GA 30260 | 2020-10-02 |
| 1578127627 | Osara Dhevmi Malalasekara | Student in an Organized Health Care Education/Training Program | Amc Family Medicine Residency Program, 1000 Corporate Center Dr Suite 200, Morrow, GA 30260 | 2019-04-24 |
| 1902360860 | Katrina Samuels | Technician | 5771 Trammell Rd. Morrow Ga, Morrow, GA 30260 | 2019-01-24 |
| 1679067870 | Atl Sport | Community/Behavioral Health | 5376 Jonesboro Rd, Lake City, GA 30260 | 2018-06-20 |
| 1487184099 | Mamie Rochell Jinks | Driver | 1541 Lakeland Cir, Lake City, GA 30260 | 2017-06-15 |
| 1598202079 | Grace Misi Nteff | Nurse Practitioner | 1000 Clayton Village, Clayton State University, School of Nursing Community, Morrow, GA 30260 | 2017-01-23 |
| 1902357908 | Morrow Family Dentistry, P.C. | Clinic/Center | 6319a Jonesboro Road, Morrow, GA 30260 | 2016-10-14 |
| 1043679418 | Elite Rehab and Weightloss | Chiropractor | 1568 Southlake Pkwy Ste C, Morrow, GA 30260 | 2016-02-15 |
| 1659758985 | Clayton State University | Nurse Practitioner | 5809 Northlake Drive, Bldg 1000, Morrow, GA 30260 | 2015-05-06 |
| 1255731519 | Care First Private Home Care | In Home Supportive Care | 2380 Fairfield Court, Morrow, GA 30260 | 2014-08-23 |
| Find all providers in zip 30260 | ||||
| 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 |
| 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 |
| 1760609895 | Cassandra Gilliam | Intermediate Care Facility, Mental Illness | 450 Winn Way, Decatur, GA 30030-1715 | 2007-04-19 |
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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.