LOWES GUARDIAN ANGEL LLC (NPI# 1942571625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942571625 |
| Entity Type | Organization |
| Organization Name | LOWES GUARDIAN ANGEL LLC |
| Practice Address |
7056 Eunice Dr. Riverdale GA 30274 |
| Mailing Address |
7056 Eunice Dr Riverdale GA 30274-3152 |
| Practice Telephone | 6785863171 |
| Mailing Telephone | 6785863171 |
| Enumeration Date | 2012-01-26 |
| Last Update Date | 2012-01-26 |
| Authorized Official Name | MR. GLENN ALAN LOWE (DDP) |
| Authorized Official Telephone | 4048084859 |
| Authorized Official Credential | BA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 251911340 | GA | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | DBHDD DEVELOPMENTAL DISABILITIES PROVIDER | 251911340 | 01 |
| Street Address |
7056 EUNICE DR. |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862507 | Todd L. Reed | Chiropractor | 83 Upper Riverdale Rd, Riverdale, GA 30274 | 2020-02-05 |
| 1487135992 | Freddie L Sallette IIi | Technician, Pathology | 385 Brookview Dr, Riverdale, GA 30274 | 2018-08-22 |
| 1366933210 | Dawn A. Paul | Nurse Practitioner | 238 Professional Ct Ste A, Riverdale, GA 30274 | 2018-05-27 |
| 1851894588 | Absolute Health Family & Urgent Care Clinic | Clinic/Center | 7574 Ga 85, Riverdale, GA 30274 | 2018-03-08 |
| 1366972127 | Jamillah Ingram | Physical Therapy Assistant | 315 Upper Riverdale Rd., Riverdale, GA 30274 | 2017-06-14 |
| 1114456514 | Grace L Kelson | Licensed Practical Nurse | 9142 Clubhouse Dr, Riverdale, GA 30274 | 2017-06-08 |
| 1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
| 1265857692 | Right Choice Enterprises LLC | Technician | 638 Sterling Ct, Riverdale, GA 30274 | 2014-02-21 |
| 1508134156 | Education System Management, Inc | Social Worker | 125 Highway 138, Riverdale, GA 30274 | 2011-12-12 |
| 1407131097 | Global Matrix International Inc. | Community/Behavioral Health | 6030 Hwy 85 Ste 202-4, Riverdale, GA 30274 | 2011-10-15 |
| Find all providers in zip 30274 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962788273 | R & K Consulting and Personal Care Homes, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6400 Beethoven Cir, Riverdale, GA 30296-2335 | 2011-11-01 |
| 1265762165 | Aspirations 2b | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8268 Creekridge Cir, Riverdale, GA 30296-1243 | 2009-12-28 |
| 1023341062 | Shirley Home Away From Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8412 Red Cedar Way, Riverdale, GA 30274-4562 | 2009-09-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790385862 | Hickory Log Vocational School Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3680 Highway 411 Ne, White, GA 30184-2427 | 2020-10-28 |
| 1801403050 | Safe Haven Personal Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10875 Abercorn St Apt 132, Savannah, GA 31419-1843 | 2020-09-30 |
| 1659987931 | Pinkies Place | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 216 Self St, Warner Robins, GA 31088-5506 | 2020-09-22 |
| 1629680293 | Caregiver Ga, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3736 Executive Center Dr Ste B, Augusta, GA 30907-2360 | 2020-08-17 |
| 1730799073 | Victory Won Counseling and Res Care Prof. Corp | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5014 Snapfinger Woods Dr, Decatur, GA 30035-4003 | 2020-08-02 |
| 1811528649 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 211 North Street, Douglas, GA 31533 | 2020-01-30 |
| 1619519709 | Gateway Behavioral Health Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 516 Freedom Trl, Brunswick, GA 31525-4712 | 2019-10-10 |
| 1215581756 | Elegant Lm Management, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1020 Meadowsong Circle, Lawrenceville, GA 30043 | 2019-08-01 |
| 1467013821 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5101 Parnell Way, Martinez, GA 30907-8896 | 2019-06-26 |
| 1013474915 | Community Service Board of East Central Georgia | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1715 Lawerence Rd, Hephzibah, GA 30815-4445 | 2019-02-27 |
| 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.