Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Amber Blaine Nicholson

Individual provider Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · NPI 1609790013

Amber Blaine Nicholson is an Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Carrollton, Georgia. Practices as a sole proprietor. Registered with an NPI since 2026.

In the registry since
2026
Specialties on file
5

Practice location Address checks out

309 Matthews Ave
Carrollton, GA 30117-3629
Phone: (561) 914-7155
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Illness Community Based Residential Treatment Facility (primary) Taxonomy 320800000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Taxonomy 320900000X
Psychiatric Residential Treatment Facility Taxonomy 323P00000X
Substance Abuse Rehabilitation Facility Taxonomy 324500000X
Respite Care Taxonomy 385H00000X

Record details

NPI number1609790013
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 7, 2026
Last updated in NPPESAugust 7, 2026
Certification dateAugust 7, 2026
Mailing address309 Matthews Ave, Carrollton, GA 30117-3629

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