BRENTWOOD NURSING LLC (NPI# 1083776520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083776520 |
| Entity Type | Organization |
| Organization Name | BRENTWOOD NURSING LLC |
| Other Organization Name | ROBERTA HEALTH CARE CENTER |
| Practice Address |
280 Myrtle Drive Roberta GA 31078 |
| Practice Telephone | 4788363101 |
| Practice Fax Number | 4788362700 |
| Mailing Telephone | 4788363101 |
| Mailing Fax Number | 4788362700 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2008-09-29 |
| Authorized Official Name | TYGH BROGDON (MANAGER) |
| Authorized Official Telephone | 7706508773 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 1-039-1747 | GA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00142777A | 05 |
| Other Name | Type Code |
|---|---|
| Roberta Health Care Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376604082 | Brentwood Nursing LLC | Skilled Nursing Facility | 604 Bluebird Blvd, Fort Valley, GA 31030-5081 | 2006-12-13 |
| 1295790681 | Brentwood Nursing LLC | Skilled Nursing Facility | 475 Washington St, Metter, GA 30439-3809 | 2006-04-19 |
| Street Address |
280 MYRTLE DRIVE |
| City | ROBERTA |
| State | GA |
| Zip Code | 31078 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649810714 | Careconnect Health, Inc. | Clinic/Center | 254 Wright Avenue, Roberta, GA 31078 | 2020-01-07 |
| 1053870451 | Lifepoint Ambulance LLC | Ambulance | 1011 Hwy 341 North, Suite 20 A, Roberta, GA 31078 | 2019-03-15 |
| 1114195914 | Phoenix Center Community Service Board | Community/Behavioral Health | 80 Wright Ave, Roberta, GA 31078 | 2008-02-14 |
| 1669517595 | Roberta Drug Co Inc | Pharmacy | 4 Wright Ave, Roberta, GA 31078 | 2007-02-20 |
| 1679583686 | Crawford County Health Department | Public Health or Welfare | 301 Mccrary St, Roberta, GA 31078 | 2006-08-09 |
| 1356505051 | Freddy N. Gaton | Family Medicine | 106 Mccrary Ave, Roberta, GA 31078 | 2008-07-11 |
| 1487746293 | Orlando Garcia Balcos | General Practice | 170 Wright Avenue, Roberta, GA 31078-0128 | 2006-09-29 |
| 1992932768 | Crawford County Board of Education | Local Education Agency (LEA) | 190 E Crusselle St, Roberta, GA 31078-4865 | 2009-06-18 |
| 1619329307 | Kenneth Hortman | Denturist | 143 E Crusselle St, Roberta, GA 31078-4866 | 2016-07-06 |
| 1760041107 | Lauren Ashley Sutton | Nurse Practitioner | 141 Mccrary Ave, Roberta, GA 31078-4915 | 2019-06-10 |
| Find all providers in zip 31078 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770755951 | Roberta Operator LLC | Skilled Nursing Facility | 420 Myrtle Dr, Roberta, GA 31078-9752 | 2008-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689281982 | Georgia Regional Health Services LLC | Skilled Nursing Facility | 3731 Lake Pass Ln, Suwanee, GA 30024-8422 | 2020-09-30 |
| 1124633268 | Lavender Mountain Senior Living Inc | Skilled Nursing Facility | 600 Eagle Lake Trl, Rome, GA 30165-2207 | 2020-09-15 |
| 1215550264 | Mesun Health Services, Inc | Skilled Nursing Facility | 88 Johnson Rd. Building #2, Lawrenceville, GA 30046 | 2020-05-26 |
| 1255966081 | Westminster Presbyterian Homes, Inc. | Skilled Nursing Facility | 1400 Live Oak Ln, Building 100, Athens, GA 30606 | 2020-03-12 |
| 1205486859 | Magnolia Manor of Liberty County, Inc. | Skilled Nursing Facility | 625 N Coastal Hwy # 17, Midway, GA 31320-3433 | 2019-09-16 |
| 1497301170 | Prestige Health Services LLC | Skilled Nursing Facility | 1770 Indian Trail Lilburn Rd Ste 420, Norcross, GA 30093-2644 | 2019-08-17 |
| 1043878721 | Keysville Ltc Management LLC | Skilled Nursing Facility | 1005 Ga Highway 88, Blythe, GA 30805-3911 | 2019-05-29 |
| 1689131724 | Favor Home Health Care Services, LLC | Skilled Nursing Facility | 51 Gallery Ct, Acworth, GA 30101-2709 | 2019-02-25 |
| 1104398866 | University Extended Care, Inc | Skilled Nursing Facility | 1005 Highway 88 N, Keysville, GA 30816 | 2018-12-19 |
| 1548745342 | Gacalhoun Snf LLC | Skilled Nursing Facility | 1387 Highway 41 N., Calhoun, GA 30701 | 2018-09-27 |
| 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.