PATRON PLACE LLC (NPI# 1457623308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457623308 |
| Entity Type | Organization |
| Organization Name | PATRON PLACE LLC |
| Practice Address |
1227 Rockbridge Rd Ste 208-196 Stone Mountain GA 30087-3064 |
| Practice Telephone | 7705731076 |
| Practice Fax Number | 7702345894 |
| Mailing Telephone | 7705731076 |
| Mailing Fax Number | 7702345894 |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2012-02-07 |
| Authorized Official Name | MRS. RONDINE GORDON (OWNER/ADMINISTRATOR) |
| Authorized Official Telephone | 7705731076 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311Z00000X | Custodial Care Facility | PCH006520 | GA | Nursing & Custodial Care Facilities |
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
PCH006520 | GA | Nursing & Custodial Care Facilities |
| Y | 310400000X | Assisted Living Facility | PCH006520 | GA | Nursing & Custodial Care Facilities |
| Street Address |
1227 ROCKBRIDGE RD STE 208-196 |
| City | STONE MOUNTAIN |
| State | GA |
| Zip Code | 30087-3064 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750653614 | Medi-cure | Hospice Care, Community Based | 1227 Rockbridge Rd Ste 208-196, Stone Mountain, GA 30087-3064 | 2012-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477176394 | Optimal Choice Telehealth | General Practice | 1227 Rockbidge Rd Sw, Ste 208-354, Stone Mountain, GA 30087 | 2020-05-27 |
| 1245882943 | Lynell Williams | Counselor | 505 Lilburn-stone Mountain Road, Suite 235, Stone Mountain, GA 30087 | 2019-07-12 |
| 1003302688 | Mark Andrew Stevens | Physical Therapist | 1227 Rockbridge Rd Ste 402, Stone Mountain, GA 30087 | 2018-07-06 |
| 1154816825 | Tuan Minh Khong | Physician Assistant | 6301 Southland Rdg, Stone Mountain, GA 30087 | 2018-06-26 |
| 1215429881 | Stephanie Martin | Nurse Practitioner | 2720 S Rockbridge Rd, Stone Mountain, GA 30087 | 2018-05-30 |
| 1578979381 | Edmund Thomas Jr. | Dentist | 2536 Rockbridge Rd Ste 103, Stone Mountain, GA 30087 | 2014-07-02 |
| 1790027688 | Robert Fanning Eaves Jr. | General Practice | 5394 Leatherstocking Lane, Stone Mountain, GA 30087 | 2013-03-19 |
| 1609128917 | Mary Marlene Muse | Lactation Consultant, Non-RN | 510 Navarre Drive, Stone Mountain, GA 30087 | 2012-10-10 |
| 1457680704 | Cleo Evans | Counselor | 5638 Manassas Run, Stone Mountain, GA 30087 | 2009-12-16 |
| 1932348521 | Lawrence Randy Sheber | Dentist | 5500-a Lilburn Stone Mountain Road, Stone Mountain, GA 30087 | 2009-02-05 |
| Find all providers in zip 30087 | ||||
| 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] |
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|---|---|---|---|---|
| 1366075848 | Liagiba, Inc | Assisted Living Facility | 518 Lake Michele Ct, Stone Mountain, GA 30088-1401 | 2020-02-13 |
| 1790174944 | Rising Star Personal Care Home | Assisted Living Facility | 5018 E Ponce De Leon Ave, Stone Mountain, GA 30083-1236 | 2015-01-12 |
| 1558589168 | Stone Mountain | Assisted Living Facility | 1745 Parke Plaza Cir, Stone Mountain, GA 30087-3498 | 2007-04-22 |
| 1184605693 | Park Springs, LLC | Assisted Living Facility | 5610 New Burmuda Rd, Stone Mountain, GA 30087 | 2005-11-10 |
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| 1639701352 | Angels Live Here Inc. | Assisted Living Facility | 89 Level Creek Rd, Suwanee, GA 30024-1779 | 2020-02-11 |
| 1295374684 | Wickshire Buford Opco LLC | Assisted Living Facility | 4355 South Lee Street, Buford, GA 30518 | 2020-01-02 |
| Find all providers with the same taxonomy | ||||
| City | STONE MOUNTAIN |
| Zip Code | 30087 |
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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.