AVITA COMMUNITY PARTNERS (NPI# 1205158813) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205158813 |
| Entity Type | Organization |
| Organization Name | AVITA COMMUNITY PARTNERS |
| Practice Address |
1763 Fernside Dr Toccoa GA 30577-8095 |
| Mailing Address |
4331 Thurmon Tanner Rd Flowery Branch GA 30542-2829 |
| Practice Telephone | 7062824542 |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2010-02-23 |
| Authorized Official Name | KAREN TUCKER (BILLING MANAGER) |
| Authorized Official Telephone | 6785135700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | MSW004930 | GA | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437489622 | Avita Community Partners | Community/Behavioral Health | 76 Hunt Martin St, Suite A, Blairsville, GA 30512-3694 | 2010-01-11 |
| 1215170105 | Avita Community Partners | Community/Behavioral Health | 4331 Thurmon Tanner Rd, Flowery Branch, GA 30542-2829 | 2009-04-08 |
| 1447492426 | Avita Community Partners | Community/Behavioral Health | 4331 Thurmon Tanner Rd, Flowery Branch, GA 30542-2829 | 2009-04-06 |
| 1245472281 | Avita Community Partners | Community/Behavioral Health | 915 Interstate Ridge Dr, Suite G, Gainesville, GA 30501-7076 | 2009-04-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | AVITA COMMUNITY PARTNERS | 4331 Thurmond Tanner Rd, Flowery Branch, GA 30542-2829 |
| Street Address |
1763 FERNSIDE DR |
| City | TOCCOA |
| State | GA |
| Zip Code | 30577-8095 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497395164 | John S. Kahle | Counselor | 1763 Fernside Dr, Toccoa, GA 30577-8095 | 2020-01-10 |
| 1093350225 | Jenifer Ivester | Behavior Technician | 1763 Fernside Dr, Toccoa, GA 30577-8095 | 2019-11-12 |
| 1386168805 | Tara Joy Peters | Social Worker | 1763 Fernside Dr, Toccoa, GA 30577-8095 | 2017-07-26 |
| 1508211459 | Jessica Austin | Social Worker | 1763 Fernside Dr, Toccoa, GA 30577-8095 | 2016-04-28 |
| 1891061867 | Mark Christopher Mazzoni | Counselor | 1763 Fernside Dr, Toccoa, GA 30577-8095 | 2012-03-23 |
| 1972816726 | Scott Nelson Howell | Clinical Nurse Specialist | 1763 Fernside Dr, Toccoa, GA 30577-8095 | 2010-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982220513 | Jennifer Lynn Harper | Counselor | 46 Rice Lewis Gilliard Way, Toccoa, GA 30577 | 2020-06-19 |
| 1912528696 | Pittard Clinic LLC | Clinic/Center | 1654 Falls Rd, Toccoa, GA 30577 | 2020-05-04 |
| 1518313733 | Shellei Adams | Occupational Therapist | 23 Big A Rd, Toccoa, GA 30577 | 2016-05-06 |
| 1902212814 | Rebecca Coursey | Counselor | 1763 Fernside Dr., Avita Community Partners, Toccoa, GA 30577 | 2014-07-11 |
| 1427478742 | Cynthia Hemphill Wansley | Pharmacist | 3886 Georgia Highway 17, Toccoa, GA 30577 | 2014-04-25 |
| 1265850168 | Karen Kelley Colwell | Pharmacist | 3886 Hwy 17, Toccoa, GA 30577 | 2014-03-29 |
| 1972808160 | Cossar Chiropractic | Chiropractor | 2766 Ga Hwy 17, Toccoa, GA 30577 | 2011-01-19 |
| 1811216070 | Georgia Mountains Community Services | Day Training, Developmentally Disabled Services | 130 Haynes St, Toccoa, GA 30577 | 2010-05-26 |
| 1942435516 | Meadows Surgical Arts | Specialist | 203 Remsdale Rd, Toccoa, GA 30577 | 2009-05-26 |
| 1609011816 | Bryan Gerald Wood | Pharmacist | 102 N Sage Street, Stewart's Downtown Discount Drugs, Toccoa, GA 30577 | 2008-12-03 |
| Find all providers in zip 30577 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417561747 | Georgia Regional Health LLC | Community Based Residential Treatment Facility, Mental Illness | 1211 Waterville Ct, Alpharetta, GA 30022-5381 | 2020-09-03 |
| 1275161192 | Monte Nido Georgia LLC | Community Based Residential Treatment Facility, Mental Illness | 124 Johnson Ferry Rd Ne, Sandy Springs, GA 30328-3004 | 2020-03-27 |
| 1811464035 | Hope Homes Recovery, LLC | Community Based Residential Treatment Facility, Mental Illness | 432 Virginia Rd, Atlanta, GA 30338-4793 | 2018-10-25 |
| 1770066029 | New Beginnings PCh of Columbus, LLC | Community Based Residential Treatment Facility, Mental Illness | 639 Lawyers Ln, Columbus, GA 31906-3812 | 2018-09-12 |
| 1588140859 | Butterfly Development, LLC | Community Based Residential Treatment Facility, Mental Illness | 1911 Grayson Highway, Suite 8-242, Grayson, GA 30017 | 2018-07-19 |
| 1326555210 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 101, Riverdale, GA 30274-1502 | 2018-01-02 |
| 1245747138 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 104, Riverdale, GA 30274-1502 | 2018-01-02 |
| 1235646217 | Clayton Center Mhaddd | Community Based Residential Treatment Facility, Mental Illness | 5930 Highway 85 Unit 401, Riverdale, GA 30274-1502 | 2017-12-29 |
| 1528574431 | House of Concrete Roses, LLC | Community Based Residential Treatment Facility, Mental Illness | 1133 Huff Rd Nw Apt 766, Atlanta, GA 30318-4327 | 2017-12-15 |
| 1508391756 | Mister Life Coach | Community Based Residential Treatment Facility, Mental Illness | 3681 N Decatur Rd Apt R11, Decatur, GA 30032-1062 | 2017-04-25 |
| Find all providers with the same taxonomy | ||||
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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.