STILESBORO PERSONAL CARE HOME LLC (NPI# 1275159386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275159386 |
| Entity Type | Organization |
| Organization Name | STILESBORO PERSONAL CARE HOME LLC |
| Practice Address |
4549 Stilesboro Rd Nw Kennesaw GA 30152-3945 |
| Practice Telephone | 6782900085 |
| Practice Fax Number | 8885400201 |
| Mailing Telephone | 6782900085 |
| Mailing Fax Number | 8885400201 |
| Enumeration Date | 2020-06-24 |
| Last Update Date | 2020-06-24 |
| Authorized Official Name | MR. GARFIELD MCCOOK (OWNER) |
| Authorized Official Telephone | 6787786335 |
| Authorized Official Credential | BS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| N | 253Z00000X | In Home Supportive Care | Agencies | ||
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Stilesboro Assisted Living | Doing Business As Name - Organization |
| Street Address |
4549 STILESBORO RD NW |
| City | KENNESAW |
| State | GA |
| Zip Code | 30152-3945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821647124 | Ashley Dover | Nurse Practitioner | 1300 Ridenour Blvd, Suite 300, Kennesaw, GA 30152 | 2019-09-09 |
| 1205306891 | Lashanda Denise Moore | Nurse Practitioner | 1600 Kennesaw Due West Rd Nw #205, Kennesaw, GA 30152 | 2018-11-27 |
| 1265901094 | Focused Loving Home Care Services LLC | In Home Supportive Care | 2151 Marne Glen Nw, Kennesaw, GA 30152 | 2018-11-22 |
| 1083199152 | Raven Ashley Thomas | Behavioral Analyst | 1619 Collins Rd Nw Ste 500, Kennesaw, GA 30152 | 2018-09-25 |
| 1821592593 | Eseovhe Egborge PC | Clinic/Center | 1600 Kennesaw Due West Rd Nw Ste 205, Kennesaw, GA 30152 | 2018-03-19 |
| 1184143059 | Kennesaw Mountain Dental Associates | Dentist | 1815 Old 41 Hwy, Ste 310, Kennesaw, GA 30152 | 2017-09-12 |
| 1265955983 | Deborah Ruth Stern Compton | Registered Nurse | 1291 Stanley Rd., Kennesaw, GA 30152 | 2017-07-25 |
| 1912452939 | Mak Anesthesia Holdings LLC | Anesthesiology | 1300 Ridenour Blvd., Ste. 300, Kennesaw, GA 30152 | 2016-08-19 |
| 1528430279 | Tineka Nichol Wyckoff | Counselor | 1967 Lake Heights Circle, Kennesaw, GA 30152 | 2015-10-21 |
| 1669753992 | American Current Care Pa | Clinic/Center | 2953 Cobb Parkway, Suite 400, Kennesaw, GA 30152 | 2011-08-31 |
| Find all providers in zip 30152 | ||||
| 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 |
|---|---|---|---|---|
| 1306105812 | Freedom Rest of Kennesaw LLC | Assisted Living Facility | 3351 Owens Brook Way Nw, Kennesaw, GA 30152-2566 | 2012-05-04 |
| 1487827226 | Assisted Living Concepts Inc | Assisted Living Facility | 3250 Quick Water Landing, Kennesaw, GA 30144 | 2008-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475086 | The We Care Homecare Foundation, Inc | Assisted Living Facility | 5701 Mableton Pkwy Sw Ste 306, Mableton, GA 30126-3360 | 2020-10-18 |
| 1871100412 | Forever Harmony PCh Inc | Assisted Living Facility | 205 Providence Walk Ct, Canton, GA 30114-8622 | 2020-09-28 |
| 1063026953 | New Hope Living Centre Dba The Fite Living Centre | Assisted Living Facility | 5 Fite St, Cartersville, GA 30120-3408 | 2020-09-08 |
| 1033723697 | Jordan Scott Seamans | Assisted Living Facility | 7778 Schomburg Rd Apt 610, Columbus, GA 31909-1928 | 2020-09-01 |
| 1225641368 | Renaissance Gainesville 1, LLC | Assisted Living Facility | 2215 Old Hamilton Pl, Gainesville, GA 30507-7893 | 2020-08-28 |
| 1770193120 | Simply Living Personal Care Home, LLC | Assisted Living Facility | 3 Berwick Ct, Savannah, GA 31406-6721 | 2020-07-31 |
| 1487276184 | 1115 Smith Opco LLC | Assisted Living Facility | 135 Market St, Thomasville, GA 31792-5782 | 2020-05-15 |
| 1497376545 | Shawitekia Johnson | Assisted Living Facility | 312 Magnolia Dr, Thomson, GA 30824-1842 | 2020-04-29 |
| 1366075848 | Liagiba, Inc | Assisted Living Facility | 518 Lake Michele Ct, Stone Mountain, GA 30088-1401 | 2020-02-13 |
| 1639701352 | Angels Live Here Inc. | Assisted Living Facility | 89 Level Creek Rd, Suwanee, GA 30024-1779 | 2020-02-11 |
| 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.