LIZZY'S ADULT COMMUNITY SERVICE CENTER (NPI# 1316285315) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316285315 |
| Entity Type | Organization |
| Organization Name | LIZZY'S ADULT COMMUNITY SERVICE CENTER |
| Practice Address |
1514 Baldwin Lakes Dr Grovetown GA 30813-5887 |
| Practice Telephone | 7065330218 |
| Practice Fax Number | 7068692015 |
| Mailing Telephone | 7065330218 |
| Mailing Fax Number | 7068692015 |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2013-01-25 |
| Authorized Official Name | MR. MELVIN PARKER III (ADMINISTRATOR) |
| Authorized Official Telephone | 7065330218 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA0600X |
Clinic/Center Specialization: Adult Day Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 366878280A | 05 | |
| GA | 366878280B | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LIZZY'S ADULT COMMUNITY SERVICE CENTER | 3118 Augusta Tech Drive, Augusta, GA 30906-3381 |
| Street Address |
1514 BALDWIN LAKES DR |
| City | GROVETOWN |
| State | GA |
| Zip Code | 30813-5887 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134435092 | Shelley Diane Mack | Chore Provider | 1514 Baldwin Lakes Dr, Grovetown, GA 30813-5887 | 2010-08-29 |
| 1801134739 | Macklander, LLC | Nursing Care | 1514 Baldwin Lakes Dr, Grovetown, GA 30813-5887 | 2013-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598276412 | Georgia Dental Professionals, PC | Dentist | 9596 Bentley Dr., Grovetown, GA 30813 | 2017-10-18 |
| 1558891895 | Jennifer M Humm | Dentist | 250 Merridian Drive, Grovetown, GA 30813 | 2017-06-19 |
| 1710335443 | The Kroger Co | Durable Medical Equipment & Medical Supplies | 435 Lewiston Rd, Grovetown, GA 30813 | 2016-06-03 |
| 1558727214 | Lynda R Green | Counselor | 426 Northrop Place, Grovetown, GA 30813 | 2016-01-11 |
| 1689002610 | Patriots Park Dental, LLC | Dentist | 701 Devika Drive, Ste 10, Grovetown, GA 30813 | 2013-10-30 |
| 1255680096 | David Schulte Jr. | Internal Medicine | 925 Branch Ct Ste 2101, Grovetown, GA 30813 | 2012-09-07 |
| 1548519481 | Ashley Roberts Saunders | Pharmacist | 869 Horizon South Parkway, Grovetown, GA 30813 | 2012-09-06 |
| 1447569694 | Wallace Allen Partridge Jr. | Pharmacist | 5104 Wrightsboro Rd., Fred's Pharmacy 1699, Grovetown, GA 30813 | 2010-10-05 |
| 1497908149 | Sharon M Blair | Registered Nurse | 7640 Pleasantville Way, Grovetown, GA 30813 | 2008-10-28 |
| 1710160791 | Rebecca Meek | Nurse Practitioner | 469 Lewiston Rd, Grovetown, GA 30813 | 2007-12-12 |
| Find all providers in zip 30813 | ||||
| Taxonomy Code | 261QA0600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Day Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609481506 | Loving Hands Foundation Incorporated | Clinic/Center | 206 Union St, Lagrange, GA 30241-3343 | 2020-09-09 |
| 1356962443 | Southern Hospitality Adult Day Health Agency LLC | Clinic/Center | 3349 Northside Dr W, Statesboro, GA 30458-2178 | 2020-04-30 |
| 1497383038 | Sheryl Dornblaser | Clinic/Center | 1180 Mckendree Church Rd Ste 107, Lawrenceville, GA 30043-5207 | 2020-03-30 |
| 1720616386 | Rainbow Senior Care Home Inc | Clinic/Center | 4405 International Blvd Ste B101, Norcross, GA 30093-3013 | 2020-03-30 |
| 1932733201 | Perfect Care, Inc | Clinic/Center | 114 Sullivan Dr, Americus, GA 31709-5534 | 2020-02-26 |
| 1710524483 | Norman Graham | Clinic/Center | 125 Marquis Dr, Fayetteville, GA 30214-1566 | 2019-12-02 |
| 1548802937 | Serenity Adult Day Health, Inc | Clinic/Center | 95 Truman Rd, Hawkinsville, GA 31036-4643 | 2019-10-17 |
| 1134778749 | Marietta Seniors Club LLC | Clinic/Center | 748 Lawrence St Ne, Marietta, GA 30060-2144 | 2019-09-06 |
| 1629626445 | Wholecare Wellness LLC | Clinic/Center | 5390 Peachtree Industrial Blvd Ste 130, Norcross, GA 30071-1566 | 2019-08-27 |
| 1750936498 | Sec of Georgia Corp | Clinic/Center | 5522 New Peachtree Rd Ste 128, Atlanta, GA 30341-2544 | 2019-08-08 |
| 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.