PENDLEY PERSONAL CARE HOME INC. (NPI# 1447532007) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447532007 |
| Entity Type | Organization |
| Organization Name | PENDLEY PERSONAL CARE HOME INC. |
| Practice Address |
2548 Central Ave Augusta GA 30904-6240 |
| Mailing Address |
Po Box 3144 Augusta GA 30914-3144 |
| Practice Telephone | 7064965884 |
| Mailing Telephone | 7064965884 |
| Enumeration Date | 2011-09-09 |
| Last Update Date | 2011-09-09 |
| Authorized Official Name | MS. KIMBERLY PENDLEY (OWNER/MANAGER) |
| Authorized Official Telephone | 7064965884 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
LCB20050032910 | GA | Nursing & Custodial Care Facilities |
| Street Address |
2548 CENTRAL AVE |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-6240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083215842 | Stewart Community Home, Inc. | Assisted Living Facility | 1125 15th St, Columbus, GA 31901-2219 | 2020-11-06 |
| 1952851602 | Gates Health Care Services, LLC | Assisted Living Facility | 400 Wallace Cir, Bloomingdale, GA 31302-8050 | 2016-10-06 |
| 1801251202 | Prime Veritas | Assisted Living Facility | 1889 Trinity Mill Dr, Dacula, GA 30019-1015 | 2015-12-30 |
| 1053730267 | Hooks Home of Care | Assisted Living Facility | 4466 Pinedale Dr, Macon, GA 31206-4530 | 2014-04-15 |
| 1699024141 | Transitional Hope Unlimited | Assisted Living Facility | 4 Harvey St Ne, Rome, GA 30161-5122 | 2012-08-30 |
| 1164782223 | Sweet Pea Personal Care Home | Assisted Living Facility | 9387 Burkhalter Rd, Statesboro, GA 30461-6765 | 2012-05-23 |
| 1215216445 | Paula's Safe House | Assisted Living Facility | 3900 Rockey Valley Dr, Conley, GA 30288-1410 | 2011-08-04 |
| 1174819619 | Prn Nursing and Alternative Living Family Care Solutions | Assisted Living Facility | 115 Lakeshore Dr S, Ivey, GA 31031-3537 | 2011-06-23 |
| 1477859841 | Fairview Community Personal Care Home, Inc. | Assisted Living Facility | 2470 Fairview Rd Se, Conyers, GA 30013-4919 | 2011-02-02 |
| 1750682571 | Intimate Estates, Inc | Assisted Living Facility | 449 Womack Rd, Covington, GA 30016-1882 | 2010-11-10 |
| 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.