MAJESTIC SENIOR LIVING TENNILLE LLC (NPI# 1689186223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689186223 |
| Entity Type | Organization |
| Organization Name | MAJESTIC SENIOR LIVING TENNILLE LLC |
| Other Organization Name | MAJESTIC SENIOR LIVING TENNILLE |
| Practice Address |
401 Martin Luther King Jr Blvd Tennille GA 31089-1438 |
| Mailing Address |
2451 Cumberland Pkwy Se Ste 3560 Atlanta GA 30339-6136 |
| Practice Telephone | 4785528881 |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2017-11-03 |
| Authorized Official Name | BRUCE ABDON (PRESIDENT) |
| Authorized Official Telephone | 3522220417 |
| Is Organization Subpart | Y |
| Parent Organization Name | MAJESTIC SENIOR LIVING, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Majestic Senior Living Tennille | Doing Business As Name - Organization |
| Street Address |
401 MARTIN LUTHER KING JR BLVD |
| City | TENNILLE |
| State | GA |
| Zip Code | 31089-1438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427369966 | Tennille Retirement Home, LLC | Assisted Living Facility | 525 N Main St, Tennille, GA 31089-1128 | 2010-06-30 |
| 1437719176 | Yontia Kewanda Brookins | Case Manager/Care Coordinator | 105 E 3rd Ave, Tennille, GA 31089-1340 | 2019-06-15 |
| 1942452065 | Lisa G Lamar | Home Health Aide | 517 Martin Luther King Jr Blvd, Tennille, GA 31089-1440 | 2008-10-21 |
| 1104876390 | Community Health Care Systems, Inc. | Clinic/Center | 116 Smith St, Tennille, GA 31089-1465 | 2006-05-11 |
| 1659787034 | Sharon Massengale | Nurse Practitioner | 116 Smith St, Tennille, GA 31089-1465 | 2014-07-07 |
| 1023353497 | Alesha Michelle Edwards | Podiatrist | 116 Smith St, Tennille, GA 31089-1465 | 2012-12-11 |
| 1053467308 | Tanya Yvonne Jones | Family Medicine | 116 Smith St, Tennille, GA 31089-1465 | 2007-01-26 |
| 1306908546 | Bridgett C Bailey | Family Medicine | 116 Smith St, Tennille, GA 31089-1465 | 2006-12-14 |
| 1306920954 | Jane Paulk | Nurse Practitioner | 116 Smith St, Tennille, GA 31089-1465 | 2006-10-24 |
| 1134694094 | Debbie Pierce Price | Counselor | 12182 Ga Highway 68 S, Tennille, GA 31089-2971 | 2018-10-08 |
| Find all providers in zip 31089 | ||||
| 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 |
|---|---|---|---|---|
| 1427369966 | Tennille Retirement Home, LLC | Assisted Living Facility | 525 N Main St, Tennille, GA 31089-1128 | 2010-06-30 |
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|---|---|---|---|---|
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| 1063026953 | New Hope Living Centre Dba The Fite Living Centre | Assisted Living Facility | 5 Fite St, Cartersville, GA 30120-3408 | 2020-09-08 |
| 1033723697 | Jordan Scott Seamans | Assisted Living Facility | 7778 Schomburg Rd Apt 610, Columbus, GA 31909-1928 | 2020-09-01 |
| 1225641368 | Renaissance Gainesville 1, LLC | Assisted Living Facility | 2215 Old Hamilton Pl, Gainesville, GA 30507-7893 | 2020-08-28 |
| 1770193120 | Simply Living Personal Care Home, LLC | Assisted Living Facility | 3 Berwick Ct, Savannah, GA 31406-6721 | 2020-07-31 |
| 1487276184 | 1115 Smith Opco LLC | Assisted Living Facility | 135 Market St, Thomasville, GA 31792-5782 | 2020-05-15 |
| 1497376545 | Shawitekia Johnson | Assisted Living Facility | 312 Magnolia Dr, Thomson, GA 30824-1842 | 2020-04-29 |
| 1366075848 | Liagiba, Inc | Assisted Living Facility | 518 Lake Michele Ct, Stone Mountain, GA 30088-1401 | 2020-02-13 |
| 1639701352 | Angels Live Here Inc. | Assisted Living Facility | 89 Level Creek Rd, Suwanee, GA 30024-1779 | 2020-02-11 |
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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.