HEAVENLY CARES ADULT DAY & PERSONAL CARE HOME (NPI# 1740581347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740581347 |
| Entity Type | Organization |
| Organization Name | HEAVENLY CARES ADULT DAY & PERSONAL CARE HOME |
| Practice Address |
562 Elles Way Griffin GA 30223-3579 |
| Practice Telephone | 6786032013 |
| Mailing Telephone | 6786032013 |
| Enumeration Date | 2010-11-12 |
| Last Update Date | 2010-11-12 |
| Authorized Official Name | ALECIA RENE CLARK (OWNER) |
| Authorized Official Telephone | 6786032013 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
GA | Nursing & Custodial Care Facilities |
| Street Address |
562 ELLES WAY |
| City | GRIFFIN |
| State | GA |
| Zip Code | 30223-3579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235783036 | Jennifer Lashawn Stevenson | Registered Nurse | 1071 Highway 16 West, Griffin, GA 30223 | 2019-07-30 |
| 1992357644 | Nikki Petty | Behavior Technician | 185 Grady Street, Griffin, GA 30223 | 2019-07-12 |
| 1568940146 | Brenda Pope | Counselor | 1710 Highway 16 West, Griffin, GA 30223 | 2018-08-05 |
| 1073025151 | Vonita Clowers | Specialist | 1424 N. Expy, Suite 115, Griffin, GA 30223 | 2017-10-30 |
| 1912427592 | Sheena Murphy | Registered Nurse | 109 N. 10th Street, Griffin, GA 30223 | 2017-06-23 |
| 1033639612 | Taralyn Rae Sams | Registered Nurse | 109 North 10th Street, Griffin, GA 30223 | 2017-06-23 |
| 1326594656 | Wendell Robinson | Registered Nurse | 109 N.10th Street, Griffin, GA 30223 | 2016-08-28 |
| 1508235466 | Trenisha Jones Mccall | Counselor | 1815 North Expressway, Griffin, GA 30223 | 2015-09-22 |
| 1104224948 | Dawn Tyus | Counselor | 424 W. Taylor Street, Griffin, GA 30223 | 2014-12-10 |
| 1003173030 | Ingles Markets Inc | Pharmacy | 1735 Zebulon Rd, Griffin, GA 30223 | 2012-04-16 |
| Find all providers in zip 30223 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457904310 | Renaissance Healthcare LLC | Custodial Care Facility | 419 Airport Rd, Griffin, GA 30224-4834 | 2019-07-19 |
| 1225697873 | Tahirah Johnston | Custodial Care Facility | 1657 Hallmark Hills Dr, Griffin, GA 30223-8790 | 2019-06-07 |
| 1922433218 | Tamika Quality Home Health | Custodial Care Facility | 1036 Swint Rd, Griffin, GA 30224-7980 | 2013-09-05 |
| 1093114423 | The Landings Care Home,llc | Custodial Care Facility | 121 W College St, Griffin, GA 30224-4220 | 2014-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679174437 | United Hands Support Services | Custodial Care Facility | 735 Ridge Rd, Canton, GA 30114-4170 | 2020-11-06 |
| 1679174429 | Golden Peak Senior Living Corp | Custodial Care Facility | 411 Edmond St, Calhoun, GA 30701-5334 | 2020-11-06 |
| 1023615531 | Lillian Womble | Custodial Care Facility | 3232 Union Church Road, Warthen, GA 31094 | 2020-10-07 |
| 1750995155 | Jacqueline Dingle | Custodial Care Facility | 604 Sugarbush Cir, Savannah, GA 31406-4434 | 2020-09-02 |
| 1114549763 | Idella's Angels | Custodial Care Facility | 270 13th Ave Sw, Cairo, GA 39828-3423 | 2020-05-16 |
| 1356962062 | Brendas Love Personal Care Home LLC | Custodial Care Facility | 8239 Queens Dr, Jonesboro, GA 30238-2946 | 2020-05-04 |
| 1801421094 | Lj's Personal Care Home, LLC | Custodial Care Facility | 415 E 18th St Sw, Rome, GA 30161-6544 | 2020-03-08 |
| 1356984041 | Manuel Carl Mckenzie IIi | Custodial Care Facility | 4893 Candlewood Ln, Stone Mountain, GA 30088-1605 | 2019-10-24 |
| 1508420613 | Rosa Amanda Hill | Custodial Care Facility | 1073 Davis Rd, Culloden, GA 31016-5843 | 2019-04-24 |
| 1427515089 | Sonshine Manor | Custodial Care Facility | 760 Tails Creek Rd, Ellijay, GA 30540-3613 | 2019-03-01 |
| 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.