BREA DECATUR LLC (NPI# 1174859904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174859904 |
| Entity Type | Organization |
| Organization Name | BREA DECATUR LLC |
| Other Organization Name | COURT AT DECATUR |
| Practice Address |
475 Irvin Ct Decatur GA 30030-1717 |
| Mailing Address |
3131 Elliott Ave Ste 500 Seattle WA 98121-1032 |
| Practice Telephone | 4042996600 |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2009-10-29 |
| Authorized Official Name | NOELLE BICKEL (LICENSING SPECIALIST) |
| Authorized Official Telephone | 2062982909 |
| Is Organization Subpart | Y |
| Parent Organization Name | BREA EMERITUS LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311500000X | Alzheimer Center (Dementia Center) | 044-03-241 | GA | Nursing & Custodial Care Facilities |
| Y | 310400000X | Assisted Living Facility | 044-03-241 | GA | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Court at Decatur | Doing Business As Name - Organization |
| Street Address |
475 IRVIN CT |
| City | DECATUR |
| State | GA |
| Zip Code | 30030-1717 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992884233 | Melissa Leigh Hayes | Speech-Language Pathologist | 475 Irvin Ct, Decatur, GA 30030-1717 | 2006-11-06 |
| 1194151480 | Mary Theresa Weaver | Physical Therapist | 475 Irvin Ct, Decatur, GA 30030-1717 | 2013-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
| 1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
| Find all providers in zip 30030 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013381235 | Altrus | Assisted Living Facility | 3363 Luxembourg Cir, Decatur, GA 30034-5418 | 2015-11-27 |
| 1013274794 | Live Oak Management, L.p. | Assisted Living Facility | 300 E Devereaux St, Decatur, TX 76234-3033 | 2012-04-18 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1952638769 | Greater Works, Inc. | Assisted Living Facility | 2551 Rainshower Dr, Decatur, GA 30034-2164 | 2009-11-16 |
| 1730373416 | Ambassador of Angels Inc. | Assisted Living Facility | 3782 Citation Dr, Decatur, GA 30034-2128 | 2007-09-05 |
| 1316069099 | Eagle Ridge of Decatur, Lp | Assisted Living Facility | 875 W Mckinley Ave, Decatur, IL 62526-3287 | 2007-04-04 |
| 1497893879 | Avondale Health Services Inc. | Assisted Living Facility | 3508 Kensington Rd, Decatur, GA 30032-1328 | 2007-02-01 |
| 1184662017 | Morningside of Decatur, L.p. | Assisted Living Facility | 2115 Point Mallard Dr Se, Decatur, AL 35601-6765 | 2006-06-03 |
| 1972961415 | Live Oak Holdings, LLC | Assisted Living Facility | 300 E Devereaux St, Decatur, TX 76234-3033 | 2016-01-28 |
| 1740662402 | Avondale Health Services Inc | Assisted Living Facility | 3508 Kensington Rd, Decatur, GA 30032-1328 | 2015-06-18 |
| Find all providers in DECATUR | ||||
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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.