The Oaks - Bethany Assisted Living, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

PCH008331 Issued in GA

Legal business name

THE OAKS - BETHANY ASSISTED LIVING, LLC

Practice address

1400 NE Main St
Vidalia, GA 30474-8644

Phone

(912) 538-9700

Fax

(912) 538-9702

NPI assigned

Oct 20, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Neil L. Pruitt Jr.

Title

Chairman and Ceo

Phone

(770) 279-6200

Specialties & licenses 1

Addresses

Other names 1

• The Oaks - Bethany Assisted Living Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413763200000",
    "number": "1003210048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "770-279-6200",
            "fax_number": "770-931-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 NE MAIN ST",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304748644",
            "telephone_number": "912-538-9700",
            "fax_number": "912-538-9702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OAKS - BETHANY ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-20",
        "last_updated": "2014-10-20",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHAIRMAN AND CEO",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "PCH008331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Oaks - Bethany Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Vidalia, GA
• Providers in Vidalia, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.