QUENCIE'S MANOR LLC (NPI# 1619403805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619403805 |
| Entity Type | Organization |
| Organization Name | QUENCIE'S MANOR LLC |
| Practice Address |
2104 Jeffersonville Rd Macon GA 31217-4517 |
| Practice Telephone | 4788325479 |
| Practice Fax Number | 4782395148 |
| Mailing Telephone | 4788325479 |
| Mailing Fax Number | 4782395148 |
| Enumeration Date | 2017-05-07 |
| Last Update Date | 2017-05-07 |
| Authorized Official Name | JOSEPH ANDREWS (ADMINISTATOR) |
| Authorized Official Telephone | 4788325479 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320700000X | Residential Treatment Facility, Physical Disabilities | PCH009157 | GA | Residential Treatment Facilities |
| Street Address |
2104 JEFFERSONVILLE RD |
| City | MACON |
| State | GA |
| Zip Code | 31217-4517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326535998 | Khuzema Mohsin | Student in an Organized Health Care Education/Training Program | 380 Hospital Drive, Building A, Suite 430, Macon, GA 31217 | 2018-04-18 |
| 1083135271 | Angela Polk | Nurse Practitioner | 310 Hospital Dr Ste 305, Macon, GA 31217 | 2017-06-28 |
| 1235662305 | Natalie Rodziewicz | Student in an Organized Health Care Education/Training Program | 380 Hospital Drive, Suite 430, Macon, GA 31217 | 2017-04-06 |
| 1427430180 | Brett Forehand | Nurse Practitioner | 330 Hospital Dr Ste 304, Macon, GA 31217 | 2015-06-18 |
| 1376772640 | Beverly Barksdale Sanders IIi | Internal Medicine | 330 Hospital Dr., Ste. 304, Macon, GA 31217 | 2009-07-08 |
| 1528218393 | Vladimir Zahradnik | Surgery | 380 Hospital Dr Bldg A Ste 320, Macon, GA 31217 | 2008-09-29 |
| 1821274267 | Mary Charmaine Estrella Campana | Physical Therapist | 380 Hospital Drive, Building A, Ste. 430, Macon, GA 31217 | 2008-01-16 |
| 1033300785 | Joann Sams Sinclair | Nurse Practitioner | 4164 Riggins Mill Road, Macon, GA 31217 | 2007-08-07 |
| 1376689737 | Grier Godfrey | Dentist | Macon-bibb County Health Department, 171 Emery Highway, Macon, GA 31217 | 2007-01-30 |
| 1053408328 | Sujatha K. Reddy | Psychiatry & Neurology | 175 Emery Highway, Macon, GA 31217 | 2006-10-06 |
| Find all providers in zip 31217 | ||||
| Taxonomy Code | 320700000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Physical 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 |
|---|---|---|---|---|
| 1184997298 | Belair At Macon | Residential Treatment Facility, Physical Disabilities | 4901 Harrison Rd., Macon, GA 31206-4135 | 2012-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114452620 | Training On The Move | Residential Treatment Facility, Physical Disabilities | 619 Hampton St, Hinesville, GA 31313-3535 | 2017-04-23 |
| 1780122010 | Pugh's Personal Care Home | Residential Treatment Facility, Physical Disabilities | 5834 St Matthews St John Church Rd, Donalsonville, GA 39845-3550 | 2017-02-07 |
| 1730621756 | Innovative Solutions Personal Care Home | Residential Treatment Facility, Physical Disabilities | 569 Phyllis Cir, Camilla, GA 31730-6438 | 2016-11-08 |
| 1285029884 | Hhsrc Neuromuscular | Residential Treatment Facility, Physical Disabilities | 5474 Oakley Industrial Blvd, Apt. 1032, Fairburn, GA 30213-4455 | 2015-03-31 |
| 1255723813 | Cotter Personal Care Home LLC | Residential Treatment Facility, Physical Disabilities | 5146 Cotter Dr, Union City, GA 30291-1812 | 2015-02-19 |
| 1770996001 | Reaves Home Care Services | Residential Treatment Facility, Physical Disabilities | 2502 Trees of Kennesaw Pkwy Nw, Kennesaw, GA 30152-8220 | 2014-06-04 |
| 1225453079 | Delroy Thomas | Residential Treatment Facility, Physical Disabilities | 8099 Revere Dr, Mcdonough, GA 30252-8924 | 2014-03-03 |
| 1134564131 | Panola Care, Cla | Residential Treatment Facility, Physical Disabilities | 3169 Pequea Dr, Lithonia, GA 30038-1119 | 2013-05-03 |
| 1235490095 | Apfa | Residential Treatment Facility, Physical Disabilities | 4776 Ben Hill Rd, Douglasville, GA 30134-4213 | 2012-06-07 |
| 1326307059 | Travelers Care Nursing Agency | Residential Treatment Facility, Physical Disabilities | 2802 Tree Summit Pkwy, Duluth, GA 30096-7932 | 2012-05-15 |
| 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.