PANOLA CARE, CLA (NPI# 1134564131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134564131 |
| Entity Type | Organization |
| Organization Name | PANOLA CARE, CLA |
| Practice Address |
3169 Pequea Dr Lithonia GA 30038-1119 |
| Practice Telephone | 7703226810 |
| Practice Fax Number | 7703226810 |
| Mailing Telephone | 7703226810 |
| Enumeration Date | 2013-05-03 |
| Last Update Date | 2013-05-03 |
| Authorized Official Name | MISS CAROL A TAVARES (DIRECTOR) |
| Authorized Official Telephone | 7703226810 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320700000X | Residential Treatment Facility, Physical Disabilities | Residential Treatment Facilities | ||
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
3169 PEQUEA DR |
| City | LITHONIA |
| State | GA |
| Zip Code | 30038-1119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548814825 | Cynthia Thomas | Nurse's Aide | 5021 Chupp Way, Lithonia, GA 30038 | 2019-07-25 |
| 1558812131 | Fresenius Medical Care Redan, LLC | Clinic/Center | 8425 Mall Parkway, Lithonia, GA 30038 | 2016-10-19 |
| 1730637059 | Flora's Loving Hands | Psychologist | 4891 Eagles Ridge Loop, Lithonia, GA 30038 | 2016-09-15 |
| 1679921886 | Mercy Oyerinde | Nurse Practitioner | 4742 Lanten Court., Lithonia, GA 30038 | 2016-05-27 |
| 1982020996 | Dina Rebecca Smith | Counselor | 6474 Gina Agha Circle, Lithonia, GA 30038 | 2014-03-14 |
| 1164765889 | Kimberly A Weems | Home Health | 6694 Brownsmill Ferry Drive, Lithonia, GA 30038 | 2013-04-01 |
| 1073850988 | Pain and Spine Solutions, LLC | Specialist | 3974 Glen Park Drive, Lithonia, GA 30038 | 2013-01-11 |
| 1629337514 | Fozi Ouse Adem | Pharmacist | 3140 Turner Hill Road, Lithonia, GA 30038 | 2012-05-11 |
| 1043579402 | Elizabeth Anne Berlin | Physician Assistant | 8825 Mall Parkway, Suite 150, Lithonia, GA 30038 | 2012-05-04 |
| 1730467911 | From Our Heart To Your Heart Personal Care Home | Custodial Care Facility | 4485 Idlewood Park, Lithonia, GA 30038 | 2011-07-22 |
| Find all providers in zip 30038 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548605330 | Flowers Community Living, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8180 Mckenzie Pl, Lithonia, GA 30058-5898 | 2013-05-07 |
| 1992024178 | A Place To Call Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6014 Idlewood Trce, Lithonia, GA 30038-6267 | 2010-05-27 |
| 1437481116 | Peace Personal Care Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1352 Regal Heights Drive, Lithonia, GA 30058 | 2010-02-05 |
| 1548439953 | Ageless Health Care & Assisted Living | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1300 Rock Chapel Rd, Lithonia, GA 30058-5835 | 2008-02-29 |
| 1164545539 | Open Hearts Personal Care Homes, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4031 Belmont Ridge Dr, Lithonia, GA 30038-4069 | 2007-04-09 |
| 1063541753 | Stellavilla | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3848 Cain Mill Dr, Lithonia, GA 30038-3868 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437764925 | Calveina Forde | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 538 Country Lake Dr, Mcdonough, GA 30252-2683 | 2020-09-10 |
| 1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
| 1023677713 | Earlean Blackwell | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1865 Waldrep Cir Se, Marietta, GA 30060-4927 | 2019-06-06 |
| 1629535216 | Carpenter Host Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 806 Grady Ave N, Douglas, GA 31533-4812 | 2019-03-01 |
| 1700354859 | View Point Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 160 Longstreet Cir, Oxford, GA 30054-2244 | 2018-11-07 |
| 1760950901 | View Point Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2116 Tudor Castle Cir, Decatur, GA 30035-2158 | 2018-11-06 |
| 1144747437 | Willie Mae Berry Pugh | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2013 Teal Court, Hephzibah, GA 30815 | 2017-08-28 |
| 1881116721 | Springhill Manor Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 600 Spring Hill Drive, Covington, GA 30016 | 2017-07-12 |
| 1093175283 | Peaceful River Residential Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 746 Rudgate Rd, Columbus, GA 31904-2929 | 2016-03-01 |
| 1548649494 | Prestige Community Living Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2328 Bigwood Trl, Atlanta, GA 30349-9049 | 2015-05-26 |
| 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.