EARLEAN BLACKWELL (NPI# 1023677713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023677713 |
| Entity Type | Individual |
| Full Name | EARLEAN BLACKWELL |
| Practice Address |
1865 Waldrep Cir Se Marietta GA 30060-4927 |
| Practice Telephone | 6784910078 |
| Mailing Telephone | 6782392239 |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2019-06-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | GA | Residential Treatment Facilities |
| Street Address |
1865 WALDREP CIR SE |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-4927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760543524 | Valley of Youth | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 352 Spring Park Rd, Marietta, SC 29661-9229 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437764925 | Calveina Forde | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 538 Country Lake Dr, Mcdonough, GA 30252-2683 | 2020-09-10 |
| 1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
| 1629535216 | Carpenter Host Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 806 Grady Ave N, Douglas, GA 31533-4812 | 2019-03-01 |
| 1700354859 | View Point Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 160 Longstreet Cir, Oxford, GA 30054-2244 | 2018-11-07 |
| 1760950901 | View Point Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2116 Tudor Castle Cir, Decatur, GA 30035-2158 | 2018-11-06 |
| 1144747437 | Willie Mae Berry Pugh | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2013 Teal Court, Hephzibah, GA 30815 | 2017-08-28 |
| 1881116721 | Springhill Manor Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 600 Spring Hill Drive, Covington, GA 30016 | 2017-07-12 |
| 1093175283 | Peaceful River Residential Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 746 Rudgate Rd, Columbus, GA 31904-2929 | 2016-03-01 |
| 1548649494 | Prestige Community Living Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2328 Bigwood Trl, Atlanta, GA 30349-9049 | 2015-05-26 |
| 1568840320 | Say So Private Home Care Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4485 Dorset Cir, Decatur, GA 30035-4206 | 2015-05-13 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on EARLEAN BLACKWELL.
| 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.