BETH'EL PERSONAL CARE HOME (NPI# 1104118108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104118108 |
| Entity Type | Organization |
| Organization Name | BETH'EL PERSONAL CARE HOME |
| Practice Address |
4327 Webb Meadows Dr Loganville GA 30052-7579 |
| Practice Telephone | 7707366439 |
| Practice Fax Number | 6786095540 |
| Mailing Telephone | 7707366439 |
| Mailing Fax Number | 6786095540 |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2011-05-09 |
| Authorized Official Name | MS. ABOSEDE ADETUTU OSHINUBI (DIRECTOR) |
| Authorized Official Telephone | 7707366439 |
| Authorized Official Credential | RD, LD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
756428113A | GA | Nursing & Custodial Care Facilities |
| Street Address |
4327 WEBB MEADOWS DR |
| City | LOGANVILLE |
| State | GA |
| Zip Code | 30052-7579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609482397 | A Better Life Together, Inc | Day Training, Developmentally Disabled Services | 3343 Woodshade Drive, Loganville, GA 30052 | 2020-09-18 |
| 1184285025 | Felicia Maria Anderson | Counselor | 272 Fox Run, Loganville, GA 30052 | 2019-06-21 |
| 1225502768 | Jackie Kabahuma Zziwa | Registered Nurse | 4072 Atlanta High Way, Loganville, GA 30052 | 2019-01-17 |
| 1598243024 | Afolasade A Adeyemo | In Home Supportive Care | 154 Towler Shoals Dr, Loganville, GA 30052 | 2018-08-06 |
| 1831688654 | Julia Smith | Physician Assistant | 2745 Loganville Hwy, Loganville, GA 30052 | 2018-05-07 |
| 1306335534 | Emily Jannine Jamshedi | Physician Assistant | 3461 Skyland Ridge Ct, Loganville, GA 30052 | 2018-05-03 |
| 1346738655 | Laura Martha Avila | Nurse Practitioner | 221 The Esplanade Way Se, Loganville, GA 30052 | 2018-04-23 |
| 1942738901 | Local Dental Partners, LLC | Clinic/Center | 4353 Atlanta Highway Suite. 300, Loganville, GA 30052 | 2017-06-02 |
| 1649702804 | Cynthia Reeves | Counselor | 4160 Logan Drive, Loganville, GA 30052 | 2017-03-28 |
| 1689049330 | Samuel S Kwon - Loganville Dmd PC | Dentist | 2101 Baker Carter Drive, Suite 200, Loganville, GA 30052 | 2015-12-07 |
| Find all providers in zip 30052 | ||||
| Taxonomy Code | 3104A0630X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Behavioral Disturbances |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but exhibit abnormal behavioral responses and habits and therefore need special guidance, assistance and/or monitoring to assure safety and well being. This type of facility requires a staff with special training in dealing with and redirecting negative, violent or destructive behaviors. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689202681 | Pt Hills Place Terraces LLC | Assisted Living Facility | 229 Peachtree Hills Place, Atlanta, GA 30305 | 2020-03-27 |
| 1477180883 | A Certain Lad Ministries Inc. | Assisted Living Facility | 693 Shannon Way, Lawrenceville, GA 30044-6310 | 2020-03-25 |
| 1174067276 | Care of Latrelle, LLC | Assisted Living Facility | 127 Waverly Way, Savannah, GA 31407-5032 | 2016-12-07 |
| 1760827190 | Distinctively Yours of Georgia, Inc | Assisted Living Facility | 8435 Magnolia Dr, Jonesboro, GA 30238-3132 | 2013-04-29 |
| 1407191257 | Litchfield Homes LLC | Assisted Living Facility | 4925 Bridle Point Pkwy, Snellville, GA 30039-3343 | 2012-12-05 |
| 1003117615 | The Mary Washington Assisted Living Home, Inc | Assisted Living Facility | 590 Mountain Oaks Pkwy, Stone Mountain, GA 30087-4732 | 2010-11-12 |
| 1114121845 | Lake Oconee Assisted Living Home | Assisted Living Facility | 105 Wilson St, Greensboro, GA 30642-1426 | 2007-06-14 |
| 1275898363 | Heavenly Arms Assisted Living | Assisted Living Facility | 11230 Highway 278 E, Covington, GA 30014-1673 | 2012-07-05 |
| 1508151176 | Georgia Residential and Community Healthcare, Inc | Assisted Living Facility | 5644 Hunters Crossing Ct, Lithonia, GA 30038-1529 | 2011-06-12 |
| City | LOGANVILLE |
| Zip Code | 30052 |
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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.