# ON-THE-CASE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gypsy Rose,Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992902951
- **Authorized official:** MISS PAMELA A. SANDERS (PRODUCTION OFFICER)
- **Authorized official phone:** (706) 306-5438

## Contact information

- **Practice address:** 4115 COLUMBIA RD, SUITE 5-324, MARTINEZ, GA 30907-0405
- **Practice address phone:** (706) 793-0646
- **Practice address fax:** (706) 793-0646
- **Mailing address:** 4115 COLUMBIA RD, SUITE 5-324, MARTINEZ, GA 30907-0405
- **Mailing address phone:** (706) 793-0646
- **Mailing address fax:** (706) 793-0646

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310500000X | Mental Illness Intermediate Care Facility | R101799 | SC | — |
| 310500000X | Mental Illness Intermediate Care Facility | RN070514 | GA | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | R101799 | SC | — |
| 313M00000X | Nursing Facility/Intermediate Care Facility | RN070514 | GA | — |
| 314000000X | Skilled Nursing Facility | R101799 | SC | — |
| 314000000X | Skilled Nursing Facility | RN070514 | GA | — |
| 315P00000X | Intellectual Disabilities Intermediate Care Facility | R101799 | SC | — |
| 315P00000X | Intellectual Disabilities Intermediate Care Facility | RN070514 | GA | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | R101799 | SC | — |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | RN070514 | GA | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | R101799 | SC | — |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | RN070514 | GA | — |
| 323P00000X | Psychiatric Residential Treatment Facility | R101799 | SC | Yes |
| 323P00000X | Psychiatric Residential Treatment Facility | RN070514 | GA | — |

## Other

- **Enumeration date:** 07/02/2007
- **Last updated:** 09/11/2025