WILLIE MAE BERRY PUGH (NPI# 1144747437) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144747437 |
| Entity Type | Individual |
| Full Name | WILLIE MAE BERRY PUGH |
| Practice Address |
2013 Teal Court Hephzibah GA 30815 |
| Mailing Address |
2013 Teal Ct Hephzibah GA 30815-7951 |
| Practice Telephone | (706) 790-4961 |
| Mailing Telephone | 7067904961 |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2017-08-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
2013 TEAL COURT |
| City | HEPHZIBAH |
| State | GA |
| Zip Code | 30815 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679091458 | Specialized Healthcare Services Inc | In Home Supportive Care | 2920 Tobacco Road, Suit A, Hephzibah, GA 30815 | 2017-08-31 |
| 1811448319 | Butterfly Gardens Hospice & Palliative Care | Hospice, Inpatient | 3112 Blackmon Court, Hephzibah, GA 30815 | 2016-10-19 |
| 1841651098 | Michelle Sherrie Coleman | Home Health Aide | 2708 Bob White Court, Hephzibah, GA 30815 | 2016-03-16 |
| 1285046409 | Allison Dionne Harden Bostic | Nurse's Aide | 1557 Brown Rd, Hephzibah, GA 30815 | 2014-05-22 |
| 1568802353 | Daryl Wolf | Chiropractor | 2742 Willis Foreman Rd., Hephzabah, GA 30815 | 2013-06-26 |
| 1336467547 | Gussie Holmes Lawson | Adult Companion | 2412 Orchard Dr., Hephzibah, GA 30815 | 2010-05-12 |
| 1275864811 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2232 Montcrief Drive, Hephzibah, GA 30815 | 2010-01-21 |
| 1376878801 | Freeman's Second Time Around Healthcare Services | Home Health | 2716 Castletown Dr, Hephzibah, GA 30815 | 2009-10-16 |
| 1205028545 | Tonia Lynn Manley | Licensed Practical Nurse | 38th Street Building 38707, Fort Gordon, GA 30815 | 2007-08-10 |
| 1336211317 | Ted Oley Oellerich | Dentist | 2357 Hwy 88, Hephzibah, GA 30815 | 2006-11-14 |
| Find all providers in zip 30815 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental 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 |
|---|---|---|---|---|
| 1619354685 | Zorana Kostoski | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4466 Fulcher Rd, Hephzibah, GA 30815-5579 | 2015-04-29 |
| 1346565926 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3015 Manchester Dr, Hephzibah, GA 30815-7166 | 2010-04-07 |
| 1164753703 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2657 Teakwood Dr, Hephzibah, GA 30815-6000 | 2010-01-21 |
| 1295066835 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4006 Ramswood Dr, Hephzibah, GA 30815-5849 | 2010-01-21 |
| 1518298116 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 848 Manderson Cir, Hephzibah, GA 30815-6781 | 2010-01-21 |
| 1275864811 | Csb of East Central Ga | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2232 Montcrief Drive, Hephzibah, GA 30815 | 2010-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437764925 | Calveina Forde | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 538 Country Lake Dr, Mcdonough, GA 30252-2683 | 2020-09-10 |
| 1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
| 1023677713 | Earlean Blackwell | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1865 Waldrep Cir Se, Marietta, GA 30060-4927 | 2019-06-06 |
| 1629535216 | Carpenter Host Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 806 Grady Ave N, Douglas, GA 31533-4812 | 2019-03-01 |
| 1700354859 | View Point Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 160 Longstreet Cir, Oxford, GA 30054-2244 | 2018-11-07 |
| 1760950901 | View Point Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2116 Tudor Castle Cir, Decatur, GA 30035-2158 | 2018-11-06 |
| 1881116721 | Springhill Manor Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 600 Spring Hill Drive, Covington, GA 30016 | 2017-07-12 |
| 1093175283 | Peaceful River Residential Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 746 Rudgate Rd, Columbus, GA 31904-2929 | 2016-03-01 |
| 1548649494 | Prestige Community Living Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2328 Bigwood Trl, Atlanta, GA 30349-9049 | 2015-05-26 |
| 1568840320 | Say So Private Home Care Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4485 Dorset Cir, Decatur, GA 30035-4206 | 2015-05-13 |
| 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.