EGO IDEAL, INC. (NPI# 1215592431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215592431 |
| Entity Type | Organization |
| Organization Name | EGO IDEAL, INC. |
| Practice Address |
4484 Covington Hwy Decatur GA 30035-1203 |
| Mailing Address |
3574 Columbia Pkwy Decatur GA 30034-3349 |
| Practice Telephone | 6787059527 |
| Mailing Telephone | 6787059527 |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2019-05-02 |
| Authorized Official Name | CHARLES L MILLER (CFO) |
| Authorized Official Telephone | 6787059527 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 305S00000X | Point of Service | Managed Care Organizations | ||
| Y | 251C00000X | Day Training, Developmentally Disabled Services | Agencies |
| Street Address |
4484 COVINGTON HWY |
| City | DECATUR |
| State | GA |
| Zip Code | 30035-1203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184761561 | Dewanda B. Jacksoon | Counselor | 4484 Covington Hwy, Suite 100a, Decatur, GA 30035-1203 | 2007-02-01 |
| 1003392259 | Shanelle Lewis | Spec/Tech, Pathology | 4484 Covington Hwy, Decatur, GA 30035 | 2018-07-11 |
| 1255512521 | Jacquelyn L. Ramsey | Community/Behavioral Health | 4484 Covington Hwy, Suite 100-a, Decatur, GA 30035-1203 | 2007-11-15 |
| 1922145325 | Marvelous Light Consultants | Counselor | 4484 Covington Hwy, Suite 100a, Decatur, GA 30035-1203 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972079978 | James L Vinson, Phd | Home Health Aide | 4050 Snapfinger Woods Drive, Suite 201, Decatur, GA 30035 | 2018-10-17 |
| 1417445206 | Kamla Gonzales | Nurse Practitioner | 5146 Miller Woods Trl, Decatur, GA 30035 | 2018-04-26 |
| 1578924924 | Alicia Marie Johnson Bryant | Social Worker | 5878 Covington Hwy, Decater, GA 30035 | 2016-03-14 |
| 1568865756 | Tracy Roberson | Counselor | 4150 Snapfinger Woods Drive, Decatur, GA 30035 | 2014-10-01 |
| 1972927861 | Tyrone D. Lane Enterprises, Incorporated | Psychologist | 5304 Panola Industrial Boulevard, Suite L, Decatur, GA 30035 | 2014-02-12 |
| 1013255355 | Mervin E Williams | Pharmacist | 2075 South Hairston, Decatur, GA 30035 | 2013-01-22 |
| 1205187572 | Mariana Simpson-walker | Speech-Language Pathologist | 4262 Clausell Ct Ste A, Decatur, GA 30035 | 2012-09-27 |
| 1053683854 | Jimiesh G Crane | Dentist | 5243 Snapfinger Woods Dr Ste 105, Decatur, GA 30035 | 2012-02-08 |
| 1568765824 | Salih Robinson | Health Educator | 2511 Lantrac Ct, Decatur, GA 30035 | 2010-12-08 |
| 1831428234 | Thomas Counseling | Counselor | 3781 Presidential Parkway, Suite 111c, Chamblee, GA 30035 | 2009-12-14 |
| Find all providers in zip 30035 | ||||
| Taxonomy Code | 251C00000X |
| Grouping | Agencies |
| Classification | Day Training, Developmentally Disabled Services |
| These agencies are authorized to provide day habilitation services to developmentally disabled individuals who live in their homes. The function of day habilitation is to assist an individual to acquire and maintain those life skills that enable the individual to cope more effectively with the demands of independent living. Also to raise the level of the individual's physical, mental, social, and vocational functioning. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528563632 | Ellis School of Atlanta, Inc. | Day Training, Developmentally Disabled Services | 189 Sams St Ste A-1, Decatur, GA 30030-4133 | 2018-03-29 |
| 1639422330 | The Smart Place | Day Training, Developmentally Disabled Services | 1916 Glenfair Rd, Decatur, GA 30035-1849 | 2012-10-18 |
| 1932405677 | M.c. Library Education Center Corp | Day Training, Developmentally Disabled Services | 2520 Park Central Blvd Ste C2, 322 P O Box Douglasville Ga 301333, Decatur, GA 30035-3924 | 2011-01-27 |
| 1306960554 | Aadd, Inc. | Day Training, Developmentally Disabled Services | 125 Clairemont Ave, Suite 300, Decatur, GA 30030-2558 | 2007-03-16 |
| 1861561995 | Macon Resoureces, Inc | Day Training, Developmentally Disabled Services | 2121 Hubbard Ave, Decatur, IL 62526-2876 | 2006-11-06 |
| 1689630253 | Addus Healthcare, Inc. | Day Training, Developmentally Disabled Services | 1190 E Pershing Rd, Suite B, Decatur, IL 62526-4727 | 2006-04-24 |
| 1538582267 | Benevolent Safe Care LLC | Day Training, Developmentally Disabled Services | 2575 Snapfinger Rd, Suite O, Decatur, GA 30034-2300 | 2014-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482397 | A Better Life Together, Inc | Day Training, Developmentally Disabled Services | 3343 Woodshade Drive, Loganville, GA 30052 | 2020-09-18 |
| 1225643653 | Auesome Achiever LLC | Day Training, Developmentally Disabled Services | 601 Alcovy St, Monroe, GA 30655-2145 | 2020-09-11 |
| 1457962797 | Southeastern Support Care Services LLC | Day Training, Developmentally Disabled Services | 3523 Fuller St, Columbus, GA 31907-2554 | 2020-08-11 |
| 1548870363 | Heart Helping Hands, LLC | Day Training, Developmentally Disabled Services | 1919 Singer Way, Lithonia, GA 30058-5578 | 2020-08-06 |
| 1073121646 | Jo Anne Ragsdale | Day Training, Developmentally Disabled Services | 4916 Lake Park Ln, Acworth, GA 30101-6253 | 2020-07-20 |
| 1447877683 | Jeremy's Place Inc. | Day Training, Developmentally Disabled Services | 4910 Jonesboro Rd Ste 201, Union City, GA 30291-2087 | 2020-07-04 |
| 1457970626 | The J&r Group Ga I Nc. | Day Training, Developmentally Disabled Services | 1910 Wood Valley Rd, Macon, GA 31211-1619 | 2020-04-08 |
| 1497307425 | Bobby Dodd Institute | Day Training, Developmentally Disabled Services | 2120 Marietta Blvd Nw, Atlanta, GA 30318-2122 | 2019-07-10 |
| 1619537453 | Cherryl Miller | Day Training, Developmentally Disabled Services | 1499 Ravenel Rd, Conley, GA 30288-2226 | 2019-06-14 |
| 1821555913 | Community Service Board of Middle Georgia | Day Training, Developmentally Disabled Services | 1444 Morgan Creek Dr, Eastman, GA 31023 | 2019-02-25 |
| 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.