J CARGILE LLC


Address: 3550 Clarkston Industrial Blvd Ste A, Clarkston, GA 30021-1331
Phone: 4046268941

J CARGILE LLC (NPI# 1659997104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1659997104
Entity Type Organization
Organization Name J CARGILE LLC
Practice Address 3550 Clarkston Industrial Blvd Ste A
Clarkston
GA 30021-1331
Mailing Address 975 Rogers St
Clarkston
GA 30021-2241
Practice Telephone 4046268941
Mailing Telephone 4046268941
Enumeration Date 2020-06-21
Last Update Date 2020-06-21
Authorized Official Name MR. JOHN W CARGILE JR. (OWNER)
Authorized Official Telephone 4046268941
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0801X Clinic/Center
Specialization: Mental Health (Including Community Mental Health Center)
Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Harbor of Dreams Art Doing Business As Name - Organization

Office Location

Street Address 3550 CLARKSTON INDUSTRIAL BLVD STE A
City CLARKSTON
State GA
Zip Code 30021-1331

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Taxonomy Information

Taxonomy Code 261QM0801X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Mental Health (Including Community Mental Health Center)

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1508994237 Downriver Mental Health Clinic PC Clinic/Center 7300 Dixie Hwy, Suite 1000, Clarkston, MI 48346-5103 2007-03-02
1609882067 Ismail B. Sendi, Md, PC Clinic/Center 6549 Town Center Dr, Suite A, Clarkston, MI 48346-4824 2006-07-31
1902382856 Giesken Counseling Services LLC Clinic/Center 5840 Lorac Dr, Clarkston, MI 48346-2915 2018-07-13
1336668565 Giesken Counseling Services LLC Clinic/Center 5840 Lorac Dr, Clarkston, MI 48346-2915 2017-09-19

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NPI Name Taxonomy Address Enumeration
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1124632013 Dunwoody Mental Health Center Clinic/Center 4594 Barclay Dr, Atlanta, GA 30338-5883 2020-09-08
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1962012153 Janel Falvey LLC Clinic/Center 340 Eisenhower Dr Bldg 300, Savannah, GA 31406-1600 2020-08-03
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Competitor

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City CLARKSTON
Zip Code 30021

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Dataset Information

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.

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