HENDERSON RESIDENTIAL, LLC (NPI# 1578510269) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578510269 |
| Entity Type | Organization |
| Organization Name | HENDERSON RESIDENTIAL, LLC |
| Other Organization Name | SOUTHERN OAKS ASSISTED LIVING |
| Practice Address |
558 White Ave Henderson TN 38340-1504 |
| Practice Telephone | 7319833200 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JAMES REIKER (TREASURER) |
| Authorized Official Telephone | 5734711113 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Southern Oaks Assisted Living | Doing Business As Name - Organization |
| Street Address |
558 WHITE AVE |
| City | HENDERSON |
| State | TN |
| Zip Code | 38340-1504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407487390 | Cornerstone Pharmacy, LLC | Pharmacy | 1330 Us Hwy 45 N Ste D, Henderson, TN 38340 | 2020-01-29 |
| 1184774358 | State of Tennessee | Public Health or Welfare | 301 Quinco Drive, Henderson, TN 38340 | 2007-01-11 |
| 1952381089 | Ronald Allen Hoffmeyer | Physician Assistant | 1132 Industrial Drive, Henderson Health Center, Henderson, TN 38340 | 2006-01-17 |
| 1487636031 | Ronald E Johnson | Dentist | 136 South Washington Ave, Henderson, TN 38340-0096 | 2005-11-18 |
| 1174835664 | Southwest Human Resource Agency | Local Education Agency (LEA) | 1527 White Avenue, Henderson, TN 38340-0264 | 2010-07-13 |
| 1366637969 | Hardeman County Community Health Center | Clinic/Center | 1132 Industrial Dr, Henderson, TN 38340-1310 | 2007-09-07 |
| 1629380639 | Candice Johnson Jones | Family Medicine | 1132 Industrial Dr, Henderson, TN 38340-1310 | 2010-07-07 |
| 1457591117 | Melaro Behavioral Consultants Inc | Clinic/Center | 225 W Sixth St, Henderson, TN 38340-1515 | 2009-02-20 |
| 1386797314 | David Allen Magee | Dentist | 1520 Cherry Creek Cv, Henderson, TN 38340-1578 | 2007-01-21 |
| 1982878146 | David A. Magee | Dentist | 1520 Cherry Creek Cv, Henderson, TN 38340-1578 | 2008-04-18 |
| Find all providers in zip 38340 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326647132 | Pacifica Cottages LLC | Assisted Living Facility | 2620 Robindale Rd, Henderson, NV 89074-1277 | 2020-10-22 |
| 1225675036 | Tranquil Breezes Home Care LLC | Assisted Living Facility | 237 Palmetto Pointe Dr, Henderson, NV 89012-5015 | 2019-12-01 |
| 1134580459 | Complete Care Group Home | Assisted Living Facility | 2437 High Vista Cir, Henderson, NV 89014-3707 | 2016-03-14 |
| 1962635334 | Wcg Arbor Place Assisted Living, LLC | Assisted Living Facility | 1200 Kilgore Dr, Henderson, TX 75652-5132 | 2009-09-01 |
| 1578766481 | Davis Family Care | Assisted Living Facility | 1421 Ross Mill Rd, Henderson, NC 27537-5965 | 2007-06-07 |
| 1588780035 | Assisted Living Concepts Inc | Assisted Living Facility | 1905 Old Nacogdoches Road, Henderson, TX 75654 | 2007-03-22 |
| 1659409613 | Green-bullock Assisted Living Center | Assisted Living Facility | 1000 Healthcare Center Rd., Henderson, NC 27536-1498 | 2007-03-01 |
| 1043241748 | Woodlawn Retirement Home | Assisted Living Facility | 2171 Ruin Creek Rd, Henderson, NC 27537-8735 | 2006-07-05 |
| 1740278126 | Senior Citizens Home Inc | Assisted Living Facility | 2275 Ruin Creek Rd, Henderson, NC 27537-8732 | 2005-10-11 |
| 1053885467 | Sweet Home Belmont LLC | Assisted Living Facility | 2908 Belmont Dr, Henderson, NV 89074-6509 | 2019-01-18 |
| Find all providers in HENDERSON | ||||
Please comment or provide details below to improve the information on HENDERSON RESIDENTIAL, LLC.
| 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.