RENEE'S PERSONAL CARE HOME, LLC (NPI# 1821392572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821392572 |
| Entity Type | Organization |
| Organization Name | RENEE'S PERSONAL CARE HOME, LLC |
| Practice Address |
1916 Ohio Ave Augusta GA 30904-5329 |
| Mailing Address |
Po Box 888 Evans GA 30809-0888 |
| Practice Telephone | 7068690775 |
| Practice Fax Number | 7068690775 |
| Mailing Telephone | 7068690775 |
| Mailing Fax Number | 7068690775 |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-01-10 |
| Authorized Official Name | MR. ISAAC T MILLER (CEO) |
| Authorized Official Telephone | 7068690775 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 121014201 | GA | Residential Treatment Facilities |
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 121014201 | GA | Residential Treatment Facilities |
| Street Address |
1916 OHIO AVE |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-5329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720345598 | Isaac T Miller | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1916 Ohio Ave, Augusta, GA 30904-5329 | 2012-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629680293 | Caregiver Ga, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3736 Executive Center Dr Ste B, Augusta, GA 30907-2360 | 2020-08-17 |
| 1467917369 | Rem New Jersey, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11 Dickerson Rd, Augusta, NJ 07822-2006 | 2019-02-05 |
| 1164995965 | Community Service Board of East Central Georgia | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1908 Driftwood Dr, Augusta, GA 30909-4113 | 2019-01-04 |
| 1407395023 | Csb of East Cental Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3535 Biltmore Pl, Augusta, GA 30906-4503 | 2017-02-15 |
| 1508305285 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3126 Richmond Hill Rd, Augusta, GA 30906-4754 | 2017-02-15 |
| 1922352582 | Scarc, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 11 Us Route 206, Suite 100, Augusta, NJ 07822 | 2012-11-05 |
| 1326310947 | Americanwork, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3957 Old Waynesboro Rd, Augusta, GA 30906-8113 | 2012-01-27 |
| 1528340379 | Tiffany A Towns | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2843 Ridgeview Dr, Augusta, GA 30909-9641 | 2011-09-16 |
| 1992006365 | Jackson's Personal Care | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2377 Dublin Dr, Augusta, GA 30906-4020 | 2010-11-16 |
| 1366510067 | Georgia Department of Human Resources | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2311 Mura Dr, Augusta, GA 30906-4819 | 2006-12-01 |
| Find all providers in AUGUSTA | ||||
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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.