BROOKS MANOR (NPI# 1205992955) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205992955 |
| Entity Type | Organization |
| Organization Name | BROOKS MANOR |
| Practice Address |
1951 Milton Rd Augusta GA 30904-5127 |
| Practice Telephone | 7067386806 |
| Practice Fax Number | 7067388404 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | PEARL WALKER (OWNER) |
| Authorized Official Telephone | 7067386806 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | GA | Nursing & Custodial Care Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BROOKS MANOR | 23 Brooks St, Charleston, WV 25301-2915 |
| New York State Corporations | BROOKS MANOR CORP. | Po Box 356, Syosset, Ny 11791 |
| Street Address |
1951 MILTON RD |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-5127 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| 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 |
|---|---|---|---|---|
| 1861904971 | Peaceful Living IIi, LLC | Assisted Living Facility | 2815 Deans Bridge Rd, Augusta, GA 30906-2704 | 2017-10-30 |
| 1134516339 | Annie Maes Health Care Services LLC. | Assisted Living Facility | 1140 14th Ave, Augusta, GA 30901-4160 | 2015-04-25 |
| 1104257922 | Turpin Hill, LLC | Assisted Living Facility | 1913 Old Savannah Rd, Augusta, GA 30901-3744 | 2013-12-04 |
| 1659709251 | Maxi Maxi's | Assisted Living Facility | 2429 Damascus Rd, Augusta, GA 30904-5410 | 2013-10-17 |
| 1649611088 | Love and Hope LLC | Assisted Living Facility | 3719 Stockholm Dr, Augusta, GA 30906-9043 | 2013-07-15 |
| 1861778748 | Heavenly Hands of Augusta, LLC | Assisted Living Facility | 3365 Tanglewood Drive, Augusta, GA 30909-3365 | 2011-10-24 |
| 1851692545 | Divine Care 1962 | Assisted Living Facility | 1962 Neptune Dr, Augusta, GA 30906-5703 | 2010-11-11 |
| 1689984379 | Amazing Grace PCh | Assisted Living Facility | 1307 Cabana Ct, Augusta, GA 30909-2419 | 2010-10-14 |
| 1215152012 | Emeritus Properties Xvi, Inc. | Assisted Living Facility | 1611 Fairway Dr, Augusta, KS 67010-2246 | 2007-04-16 |
| 1164564191 | Spice of Life | Assisted Living Facility | 1458 Mill St, Augusta, GA 30901-3591 | 2007-02-13 |
| Find all providers in AUGUSTA | ||||
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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.