AGELESS HEALTH CARE & ASSISTED LIVING (NPI# 1548439953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548439953 |
| Entity Type | Organization |
| Organization Name | AGELESS HEALTH CARE & ASSISTED LIVING |
| Practice Address |
1300 Rock Chapel Rd Lithonia GA 30058-5835 |
| Practice Telephone | 6785265464 |
| Mailing Telephone | 6785265464 |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2008-02-29 |
| Authorized Official Name | JACQUELINE PEAN (OWNER) |
| Authorized Official Telephone | 6785265464 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | GA | Residential Treatment Facilities |
| Street Address |
1300 ROCK CHAPEL RD |
| City | LITHONIA |
| State | GA |
| Zip Code | 30058-5835 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821603606 | Sherenda Lashawn Ellis | Contractor | 1859 Petite Lane, Lithonia, GA 30058 | 2020-09-09 |
| 1477186807 | Reset Recovery Health Center LLC | Substance Abuse Rehabilitation Facility | 6978 Main St, Lithonia, GA 30058 | 2020-02-13 |
| 1346726122 | Myorganics | Spec/Tech, Pathology | 5910 Shadow Rock Dr, Lithonia, GA 30058 | 2018-07-16 |
| 1699251884 | Enriching Medical Transport | Ambulance | 2260 Lithonia Industrial Blvd., Ste N-b, Lithonia, GA 30058 | 2018-07-11 |
| 1841789914 | Milner Vein and Vascular LLC | Surgery | 5700 Hillandale Dr Ste 150, Lithonia, GA 30058 | 2018-05-04 |
| 1215451265 | Brittany Rawlings | Home Health | 6127 Howell Ridge, Lithonia, GA 30058 | 2017-08-01 |
| 1982125571 | Bella Intellectum, LLC | Technician/Technologist | 6803 Edmonton Ct., Lithonia, GA 30058 | 2017-07-05 |
| 1528589397 | Arlene Dennis | Registered Nurse | 6022 Arnor Links Road, Lithonia, GA 30058 | 2017-07-03 |
| 1417401746 | Two Caring Hands Private Home Care | Home Health | 1959 Singers Way, Lithonia, GA 30058 | 2016-08-03 |
| 1518347467 | Ortho Injury and Wellness Center Inc. | Clinic/Center | 6148 A Covington Hwy, Lithonia, GA 30058 | 2015-06-05 |
| Find all providers in zip 30058 | ||||
| Taxonomy Code | 320600000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548605330 | Flowers Community Living, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 8180 Mckenzie Pl, Lithonia, GA 30058-5898 | 2013-05-07 |
| 1992024178 | A Place To Call Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6014 Idlewood Trce, Lithonia, GA 30038-6267 | 2010-05-27 |
| 1437481116 | Peace Personal Care Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1352 Regal Heights Drive, Lithonia, GA 30058 | 2010-02-05 |
| 1164545539 | Open Hearts Personal Care Homes, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 4031 Belmont Ridge Dr, Lithonia, GA 30038-4069 | 2007-04-09 |
| 1063541753 | Stellavilla | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 3848 Cain Mill Dr, Lithonia, GA 30038-3868 | 2007-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437764925 | Calveina Forde | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 538 Country Lake Dr, Mcdonough, GA 30252-2683 | 2020-09-10 |
| 1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
| 1023677713 | Earlean Blackwell | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1865 Waldrep Cir Se, Marietta, GA 30060-4927 | 2019-06-06 |
| 1629535216 | Carpenter Host Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 806 Grady Ave N, Douglas, GA 31533-4812 | 2019-03-01 |
| 1700354859 | View Point Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 160 Longstreet Cir, Oxford, GA 30054-2244 | 2018-11-07 |
| 1760950901 | View Point Health | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2116 Tudor Castle Cir, Decatur, GA 30035-2158 | 2018-11-06 |
| 1144747437 | Willie Mae Berry Pugh | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2013 Teal Court, Hephzibah, GA 30815 | 2017-08-28 |
| 1881116721 | Springhill Manor Inc. | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 600 Spring Hill Drive, Covington, GA 30016 | 2017-07-12 |
| 1093175283 | Peaceful River Residential Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 746 Rudgate Rd, Columbus, GA 31904-2929 | 2016-03-01 |
| 1548649494 | Prestige Community Living Center | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 2328 Bigwood Trl, Atlanta, GA 30349-9049 | 2015-05-26 |
| 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.