JACKSON'S PERSONAL CARE (NPI# 1992006365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992006365 |
| Entity Type | Organization |
| Organization Name | JACKSON'S PERSONAL CARE |
| Practice Address |
2377 Dublin Dr Augusta GA 30906-4020 |
| Practice Telephone | 7067982127 |
| Practice Fax Number | 7064967305 |
| Mailing Telephone | 7067982127 |
| Mailing Fax Number | 7064967305 |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-16 |
| Authorized Official Name | MRS. VELMA L JACKSON (OWNER) |
| Authorized Official Telephone | 7067936487 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 121013781 | GA | Residential Treatment Facilities |
| Street Address |
2377 DUBLIN DR |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30906-4020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255969432 | Barton Chapel Dental Group, LLC | Dentist | 2755 Barton Chapel Road, Augusta, GA 30906 | 2020-04-01 |
| 1255897419 | Pediatric Mobility Innovations | Durable Medical Equipment & Medical Supplies | 3114 Augusta Tech Drive Suite 404, Augusta, GA 30906 | 2019-02-13 |
| 1023539731 | Kristy Lee Gibbs | Registered Nurse | 3421 Mike Padgett Hwy Bldg C, Augusta, GA 30906 | 2017-07-03 |
| 1194186031 | Clifton Nane Williams | Counselor | 3230 Hampton Circle, Augusta, GA 30906 | 2016-03-18 |
| 1376929661 | Catherine A. Ganzy | Social Worker | 3405 Mike Padgett Highway; Building 201, East Central Regional Hosptial, Augusta, GA 30906 | 2015-08-10 |
| 1962810358 | Fatemeh Azadeh Paziraei | Dentist | 1631 Gordon Highway, Augusta Smiles Youth Dentistry, Augusta, GA 30906 | 2014-07-29 |
| 1568809770 | Brandon Jennings | Occupational Therapy Assistant | 2388 Old Mcduffie Rd, Augusta, GA 30906 | 2013-05-29 |
| 1811266646 | Eddie P Johnson IIi, Dmd, PC | Preferred Provider Organization | 2755 Barton Chapel Rd, Augusta, GA 30906 | 2011-12-23 |
| 1366739021 | Kerensa A Cooks | Registered Nurse | 3421 Mike Padgett Highway, Serenity Behavioral Health Systems, Augusta, GA 30906 | 2011-07-01 |
| 1265737423 | Pidcock Chiropractic, Inc. | Chiropractor | 3028 Peach Orchard Rd., Augusta, GA 30906 | 2011-01-20 |
| Find all providers in zip 30906 | ||||
| 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 |
| 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 |
| 1083154553 | Csb of East Central Ga | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3126 Richmond Hill Rd, Augusta, GA 30906-4754 | 2017-03-03 |
| 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.