SOUTHERN MANOR SENIOR LIVING, LLC (NPI# 1568860393) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568860393 |
| Entity Type | Organization |
| Organization Name | SOUTHERN MANOR SENIOR LIVING, LLC |
| Practice Address |
184 Pine Ln Washington GA 30673-4035 |
| Practice Telephone | 7066783330 |
| Practice Fax Number | 7066784440 |
| Mailing Telephone | 7066783330 |
| Mailing Fax Number | 7066784440 |
| Enumeration Date | 2014-12-10 |
| Last Update Date | 2015-11-13 |
| Authorized Official Name | DEBRA W. SHERRER (ADMINISTRATOR) |
| Authorized Official Telephone | 7066783330 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | PCH008530 | GA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 003156697A | 05 | |
| GA | 003158657A | 05 |
| Street Address |
184 PINE LN |
| City | WASHINGTON |
| State | GA |
| Zip Code | 30673-4035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265598932 | Caring Hearts Health Services | Assisted Living Facility | 184 Pine Ln, Washington, GA 30673-4035 | 2006-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477893766 | Andrew D Smoot | Specialist/Technologist | 119 W Robert Toombs Ave, A, Washington, GA 30673 | 2013-02-22 |
| 1033418975 | Hulin Transportation, Inc. | Respite Care | 906 Sandtown Rd., Washington, GA 30673 | 2011-03-17 |
| 1730404047 | Brian James Ackermann | Chiropractor | 22 West Robert Toombs Ave, R, Washington, GA 30673 | 2010-03-30 |
| 1922129105 | David T. Kirk and Associates | Clinic/Center | 206 Hospital Dr., Washington, GA 30673 | 2007-04-03 |
| 1316089097 | Medstar Homecare | Durable Medical Equipment & Medical Supplies | 906 Sandtown Road, Washington, GA 30673 | 2007-02-12 |
| 1639249600 | Wilkes County Board of Education | Local Education Agency (LEA) | 313 A. North Alexander Ave, Wilkes, GA 30673 | 2006-11-08 |
| 1396788097 | Wilkes County Board of Commissioners | Ambulance | 105 Marshall Street, Washington, GA 30673 | 2006-06-13 |
| 1568507879 | Charles Joseph Fievet Sr. | Pharmacist | 115 E Robert Toombs Ave, Washington, GA 30673 | 2007-02-21 |
| 1629378831 | Jessica Jo Fields | Physician Assistant | 212 Hospital Drive, Washington, GA 30673-0568 | 2010-10-22 |
| 1043263031 | Pruitthealth - Washington, LLC | Skilled Nursing Facility | 112 Hospital Drive, Washington, GA 30673-0578 | 2006-05-18 |
| Find all providers in zip 30673 | ||||
| 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 |
|---|---|---|---|---|
| 1609415041 | Bra Health Care Services, LLC | Assisted Living Facility | 900 K St Ne, Washington, DC 20002-3724 | 2020-01-02 |
| 1174082549 | Paradise At Georgia Ave, LLC | Assisted Living Facility | 5100 Georgia Ave Nw, Washington, DC 20011-3958 | 2019-03-15 |
| 1093282782 | Joel C. Horne & Co., Inc. | Assisted Living Facility | 1078 N Coral Canyon Blvd, Washington, UT 84780-2777 | 2018-10-31 |
| 1386164705 | Eckington House Mental Health Service LLC | Assisted Living Facility | 3030 30th St Se, Washington, DC 20020-1674 | 2017-06-27 |
| 1831596782 | Nissi Homes LLP | Assisted Living Facility | 5915 Dix St Ne, Washington, DC 20019-6968 | 2014-11-20 |
| 1366850885 | Iyeshia Anderson | Assisted Living Facility | 500 44th St Ne, Washington, DC 20019-8044 | 2014-07-28 |
| 1851729529 | 2905 Alf, LLC | Assisted Living Facility | 2905 11th St Nw, Washington, DC 20001-3903 | 2013-10-16 |
| 1265865349 | Assisted Living Centers of America,llc | Assisted Living Facility | 1717 Pennsylvania Ave Nw Ste 1025, Washington, DC 20006-3951 | 2013-08-13 |
| 1598002024 | Americare At Vicotrian Manor of Washington, LLC | Assisted Living Facility | 2701 Rabbit Trail Dr, Washington, MO 63090 | 2013-01-03 |
| 1558659029 | Victorian Manor of Washington, Inc | Assisted Living Facility | 2800 Rabbit Trail Dr, Washington, MO 63090-6737 | 2011-07-18 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 30673 |
Please comment or provide details below to improve the information on SOUTHERN MANOR SENIOR LIVING, LLC.
| 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.