CHOICE PERSONAL CARE HOME (NPI# 1235369513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235369513 |
| Entity Type | Organization |
| Organization Name | CHOICE PERSONAL CARE HOME |
| Practice Address |
1030 Scott Rd Riverdale GA 30296-1558 |
| Mailing Address |
3850 Pebble Beach Dr College Park GA 30349-3632 |
| Practice Telephone | 4244776536 |
| Practice Fax Number | 7709695958 |
| Mailing Telephone | 4244776536 |
| Mailing Fax Number | 7709695958 |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2009-07-21 |
| Authorized Official Name | MRS. RUBY L LEWIS (OWNER) |
| Authorized Official Telephone | 4244776536 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Street Address |
1030 SCOTT RD |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30296-1558 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417558594 | James D Hickman | Home Health Aide | 2252 Addison Park, Riverdale, GA 30296 | 2020-11-04 |
| 1255973251 | Octavia Bostic | Nurse's Aide | 7670 Creekside Lane, Riverdale, GA 30296 | 2019-10-10 |
| 1548746829 | Verna Stoner-frazier | Physical Therapist | 1542 Bethaven Rd, Riverdale, GA 30296 | 2018-07-19 |
| 1346762705 | Letty Searcy | Case Manager/Care Coordinator | 7125 E. Village Ct, Riverdale, GA 30296 | 2017-07-07 |
| 1225402639 | Optima Physical Therapy Services | Clinic/Center | 808 Commerce Boulevard, Riverdale, GA 30296 | 2015-11-23 |
| 1437409224 | Mobile Nursing Service LLC | Nursing Care | 829 Scott Rd, Riverdale, GA 30296 | 2012-09-19 |
| 1104069517 | Taina S. Holly | Licensed Practical Nurse | 1234 Elgin Way, Riverdale, GA 30296 | 2009-04-15 |
| 1386720118 | Absolute Healthcare & Rehab Center | Chiropractor | 1807 Hwy 138 Sw, Riverdale, GA 30296 | 2006-10-27 |
| 1467558650 | Daniel Tesfa Redie | Dentist | 1849 Hwy 138, Riverdale, GA 30296 | 2006-09-15 |
| 1033214184 | Malcolm Hill | Chiropractor | 1296 Hwy 138, Suite 105, Riverdale, GA 30296 | 2006-09-13 |
| Find all providers in zip 30296 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104295187 | Lifeline Incoporation | Custodial Care Facility | 6823d Riverdale Rd Apt D1, Riverdale, MD 20737-1835 | 2015-09-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174437 | United Hands Support Services | Custodial Care Facility | 735 Ridge Rd, Canton, GA 30114-4170 | 2020-11-06 |
| 1679174429 | Golden Peak Senior Living Corp | Custodial Care Facility | 411 Edmond St, Calhoun, GA 30701-5334 | 2020-11-06 |
| 1023615531 | Lillian Womble | Custodial Care Facility | 3232 Union Church Road, Warthen, GA 31094 | 2020-10-07 |
| 1750995155 | Jacqueline Dingle | Custodial Care Facility | 604 Sugarbush Cir, Savannah, GA 31406-4434 | 2020-09-02 |
| 1114549763 | Idella's Angels | Custodial Care Facility | 270 13th Ave Sw, Cairo, GA 39828-3423 | 2020-05-16 |
| 1356962062 | Brendas Love Personal Care Home LLC | Custodial Care Facility | 8239 Queens Dr, Jonesboro, GA 30238-2946 | 2020-05-04 |
| 1801421094 | Lj's Personal Care Home, LLC | Custodial Care Facility | 415 E 18th St Sw, Rome, GA 30161-6544 | 2020-03-08 |
| 1356984041 | Manuel Carl Mckenzie IIi | Custodial Care Facility | 4893 Candlewood Ln, Stone Mountain, GA 30088-1605 | 2019-10-24 |
| 1457904310 | Renaissance Healthcare LLC | Custodial Care Facility | 419 Airport Rd, Griffin, GA 30224-4834 | 2019-07-19 |
| 1225697873 | Tahirah Johnston | Custodial Care Facility | 1657 Hallmark Hills Dr, Griffin, GA 30223-8790 | 2019-06-07 |
| 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.