FIVE STAR QUALITY CARE-GA, LLC (NPI# 1740229707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740229707 |
| Entity Type | Organization |
| Organization Name | FIVE STAR QUALITY CARE-GA, LLC |
| Other Organization Name | NORTHLAKE GARDENS |
| Practice Address |
1300 Montreal Rd Tucker GA 30084-8141 |
| Mailing Address |
400 Centre St Newton MA 02458-2094 |
| Practice Telephone | 7709340034 |
| Practice Fax Number | 7709340055 |
| Mailing Telephone | 6177968387 |
| Mailing Fax Number | 6177968385 |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2016-06-27 |
| Authorized Official Name | BRUCE J MACKEY JR. (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6177968214 |
| Is Organization Subpart | Y |
| Parent Organization Name | FIVE STAR QUALITY CARE-GA, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 044-03-019-1 | GA | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Northlake Gardens | Doing Business As Name - Organization |
| Street Address |
1300 MONTREAL RD |
| City | TUCKER |
| State | GA |
| Zip Code | 30084-8141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265089379 | Snh Georgia Tenant LLC | Assisted Living Facility | 1300 Montreal Rd, Tucker, GA 30084-8141 | 2019-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609401355 | Excellent Medical Transport | Ambulance | 4378 Sentry Dr, Tucker, GA 30084 | 2020-03-03 |
| 1811468796 | Caleb Lee Ebbets | Physical Therapist | 1459 Montreal Road, Medical Office Building, Suite 301, Tucker, GA 30084 | 2018-12-17 |
| 1417436130 | Benjamin Han Wook Chong | Physical Therapist | 1460 Montreal Road East, Suite 300, Tucker, GA 30084 | 2018-08-13 |
| 1336659325 | Lavista Acupuncture and Herbal Medicine | Acupuncturist | 4915 Lavista Rd, Tucker, GA 30084 | 2017-10-04 |
| 1699294207 | Debrica Butler | Counselor | 1021 Oak Chase Dr., Apt C, Tucker, GA 30084 | 2017-09-14 |
| 1295264695 | Jolanta Wazgowska Hopkins | Social Worker | 4404 Idlewood Lane, Tucker, GA 30084 | 2017-06-08 |
| 1164956157 | Sage Dental Group of Georgia LLC | Dentist | 4320 Lavista Rd, Suite C119, Tucker, GA 30084 | 2017-04-17 |
| 1689107807 | Mashail Manzur | Podiatrist | 1460 Montreal Rd E, Ste 275, Tucker, GA 30084 | 2017-04-05 |
| 1053765578 | Jessica Spruyt | Speech-Language Pathologist | 3756 Lavista Rd Suite 104, Tucker, GA 30084 | 2016-04-21 |
| 1265802318 | Spine and Orthopedics of Atlanta, LLC | Clinic/Center | 1462 Montreal Rd Ste 218, Tucker, GA 30084 | 2015-10-01 |
| Find all providers in zip 30084 | ||||
| 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 |
|---|---|---|---|---|
| 1689712721 | Avondale Health Services, Inc | Assisted Living Facility | 2553 Sandpiper Dr, Tucker, GA 30084-2910 | 2007-02-01 |
| 1598803983 | Avondale Health Services, Inc. | Assisted Living Facility | 3965 Gloucester Dr, Tucker, GA 30084-7222 | 2007-02-01 |
| 1265089379 | Snh Georgia Tenant LLC | Assisted Living Facility | 1300 Montreal Rd, Tucker, GA 30084-8141 | 2019-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475086 | The We Care Homecare Foundation, Inc | Assisted Living Facility | 5701 Mableton Pkwy Sw Ste 306, Mableton, GA 30126-3360 | 2020-10-18 |
| 1871100412 | Forever Harmony PCh Inc | Assisted Living Facility | 205 Providence Walk Ct, Canton, GA 30114-8622 | 2020-09-28 |
| 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 |
| 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.