FAIRVIEW COMMUNITY PERSONAL CARE HOME, INC.


Address: 2470 Fairview Rd Se, Conyers, GA 30013-4919
Phone: 7707857800

FAIRVIEW COMMUNITY PERSONAL CARE HOME, INC. (NPI# 1477859841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1477859841
Entity Type Organization
Organization Name FAIRVIEW COMMUNITY PERSONAL CARE HOME, INC.
Practice Address 2470 Fairview Rd Se
Conyers
GA 30013-4919
Practice Telephone 7707857800
Practice Fax Number 6786091387
Mailing Telephone 7707857800
Mailing Fax Number 6786091387
Enumeration Date 2011-02-02
Last Update Date 2011-02-18
Authorized Official Name MR. MONTILIA MAURICE TRIPP (PRESIDENT/CEO)
Authorized Official Telephone 6785703149
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3104A0625X Assisted Living Facility
Specialization: Assisted Living, Mental Illness
107-01-054-1 GA Nursing & Custodial Care Facilities

Office Location

Street Address 2470 FAIRVIEW RD SE
City CONYERS
State GA
Zip Code 30013-4919

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1043735244 Niki Tanyell Davis Licensed Practical Nurse 1403 Windy Hill Court, Conyers, GA 30013 2017-08-08
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Taxonomy Information

Taxonomy Code 3104A0625X
Grouping Nursing & Custodial Care Facilities
Classification Assisted Living Facility
Specialization Assisted Living, Mental Illness

Taxonomy Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies.
Notes: [7/1/2003: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1083215842 Stewart Community Home, Inc. Assisted Living Facility 1125 15th St, Columbus, GA 31901-2219 2020-11-06
1952851602 Gates Health Care Services, LLC Assisted Living Facility 400 Wallace Cir, Bloomingdale, GA 31302-8050 2016-10-06
1801251202 Prime Veritas Assisted Living Facility 1889 Trinity Mill Dr, Dacula, GA 30019-1015 2015-12-30
1053730267 Hooks Home of Care Assisted Living Facility 4466 Pinedale Dr, Macon, GA 31206-4530 2014-04-15
1699024141 Transitional Hope Unlimited Assisted Living Facility 4 Harvey St Ne, Rome, GA 30161-5122 2012-08-30
1164782223 Sweet Pea Personal Care Home Assisted Living Facility 9387 Burkhalter Rd, Statesboro, GA 30461-6765 2012-05-23
1447532007 Pendley Personal Care Home Inc. Assisted Living Facility 2548 Central Ave, Augusta, GA 30904-6240 2011-09-09
1215216445 Paula's Safe House Assisted Living Facility 3900 Rockey Valley Dr, Conley, GA 30288-1410 2011-08-04
1174819619 Prn Nursing and Alternative Living Family Care Solutions Assisted Living Facility 115 Lakeshore Dr S, Ivey, GA 31031-3537 2011-06-23
1750682571 Intimate Estates, Inc Assisted Living Facility 449 Womack Rd, Covington, GA 30016-1882 2010-11-10
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Competitor

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City CONYERS
Zip Code 30013

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Dataset Information

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.

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