BREAD OF LIFE ASSISTED LIVING CORPORATION (NPI# 1861740904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861740904 |
| Entity Type | Organization |
| Organization Name | BREAD OF LIFE ASSISTED LIVING CORPORATION |
| Practice Address |
2001 Martin Luther King Jr Dr Sw Suite 450-a Atlanta GA 30310-1101 |
| Practice Telephone | 6787328191 |
| Practice Fax Number | 4045646487 |
| Mailing Telephone | 6787328191 |
| Mailing Fax Number | 4045646487 |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2012-08-21 |
| Authorized Official Name | MRS. CHRISTINE NWANKWO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6787328191 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | GA | Agencies | |
| N | 251J00000X | Nursing Care | GA | Agencies | |
| N | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
GA | Nursing & Custodial Care Facilities | |
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
GA | Nursing & Custodial Care Facilities |
| Street Address |
2001 MARTIN LUTHER KING JR DR SW SUITE 450-A |
| City | ATLANTA |
| State | GA |
| Zip Code | 30310-1101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750386637 | Walter Berosky Atkins | Podiatrist | 2001 Martin Luther King Jr Dr Sw, Ste 300, Atlanta, GA 30310-5801 | 2005-06-16 |
| 1356959407 | 2 Nextlevel Consulting, LLC | Counselor | 2001 Martin Luther King Jr Dr Sw, Atlanta, GA 30310-1101 | 2020-07-15 |
| 1598373656 | Premier Comprehensive Services, LLC | Counselor | 2001 Martin Luther King Jr Dr Sw, Atlanta, GA 30310-1101 | 2020-07-15 |
| 1679111454 | Pre Wellness Care Atlanta | Clinic/Center | 2001 Martin Luther King Jr Dr Sw, Atlanta, GA 30310-1101 | 2019-12-12 |
| 1578090601 | Agape Community Integrated Health Systems, Inc. | Counselor | 2001 Martin Luther King Jr Dr Sw, Suite 420, Atlanta, GA 30310-1101 | 2017-05-19 |
| 1497299804 | Moore Consulting Counseling Group | Social Worker | 2001 Martin Luther King Jr Dr Sw, Suite 409, Atlanta, GA 30310-1101 | 2016-12-05 |
| 1093169211 | Beatrice C Obiekwe | Registered Nurse | 2001 Martin Luther King Jr Dr Sw, Suite 409, Atlanta, GA 30310-1101 | 2016-04-14 |
| 1871967208 | Nancy Adiri | Registered Nurse | 2001 Martin Luther King Jr Dr Sw, Suite 409, Atlanta, GA 30310-1101 | 2015-11-23 |
| 1306215777 | Krishna Clanton | Counselor | 2001 Martin Luther King Jr Dr Sw, Suite 540, Atlanta, GA 30310-1101 | 2015-09-16 |
| 1083001796 | T2s Enterprises, LLC | Clinic/Center | 2001 Martin Luther King Jr Dr Sw, Suite 540, Atlanta, GA 30310-1101 | 2015-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134775208 | Naesm Mens Health and Wellness Center | Clinic/Center | 2140 Martin Luther King Jr Dr Sw Ste 201, Atlanta, GA 30310 | 2019-08-14 |
| 1588219810 | Dayana Regis | Pediatrics | 808 York Ave Sw, Atlanta, GA 30310 | 2019-08-04 |
| 1629636683 | Manan Shah | Student in an Organized Health Care Education/Training Program | 720 Westview Dr, Sw Morehouse School of Medicine/gme, Atlanta, GA 30310 | 2019-06-04 |
| 1780242420 | Fortunate Amarachukwu Ejimone | Student in an Organized Health Care Education/Training Program | 720 Westview Dr. Sw Morehouse School of Medicine/gme, Atlanta, GA 30310 | 2019-05-29 |
| 1922589589 | Bria Campbell | Counselor | 1009 Windsor St Sw, Atlanta, GA 30310 | 2018-08-22 |
| 1821583584 | Onyedikachi Kenneth Michaels | Student in an Organized Health Care Education/Training Program | Morehouse School of Medicine / Gme, 720 Westview Dr, Sw, Atlanta, GA 30310 | 2018-06-26 |
| 1881185387 | Precious Oghenefejiro Odunvbun | Student in an Organized Health Care Education/Training Program | 720 West View Dr Sw Morehouse School of Medicine/gme, Department of Medicine, Atlanta, GA 30310 | 2018-05-21 |
| 1598253908 | Chinonyelum Doris Nwagbara | Student in an Organized Health Care Education/Training Program | Morehouse School of Medicine, Gme 720 Westview Drive Sw, Atlanta, GA 30310 | 2018-05-01 |
| 1679060552 | Danielle Nicole Oliver | Student in an Organized Health Care Education/Training Program | Morehouse School of Medicine/gme 720 Westview Dr Sw, Atlanta, GA 30310 | 2018-04-17 |
| 1376049072 | Ngozi Egondu Okanu | Student in an Organized Health Care Education/Training Program | Gme 720 Westview Dr, Sw, Atlanta, GA 30310 | 2018-04-02 |
| Find all providers in zip 30310 | ||||
| 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 |
|---|---|---|---|---|
| 1417253014 | Universal Indemnity Group | Assisted Living Facility | 235 Peachtree St, Suite #400, Atlanta, GA 30303-1401 | 2011-01-31 |
| 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 |
| 1447532007 | Pendley Personal Care Home Inc. | Assisted Living Facility | 2548 Central Ave, Augusta, GA 30904-6240 | 2011-09-09 |
| 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 |
| 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.