NPI age
19 years
Enumerated 2007-02-20
● Active Type 2 · Organization
Subpart
Shallowford Group Home
Shallowford Group Home is 1 of 2449 community/behavioral health organizations in Georgia.
Primary specialty
Community/Behavioral Health
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Van Der Merwe
Coo
Last NPPES update
2024-08-19
Source: monthly bulk 2026-05
How this organization compares
Across 2449 active community/behavioral health providers in Georgia.
NPI age
19 years
↑ 6 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-02Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
2473 Shallowford Rd Ne
Atlanta, GA 303451363
Mailing address
445 Winn Way Fl 4
Decatur, GA 300301707
Authorized official
Fabio Bruno Van Der Merwe
Coo
📞 4042943836
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Sydney Clark Registered Nurse NPI 1871225334
Specialties
-
Community/Behavioral Health PrimaryA private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals...
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Shallowford Group Home
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
Subpart of Dekalb Community Service Board.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.