Angels at Divine Retreat LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

ANGELS AT DIVINE RETREAT LLC

Doing business as

Angels Divine Personal Care Home

Practice address

3065 Jeffersonville Rd
Macon, GA 31217-5117

Phone

(478) 257-7136

Fax

(478) 257-7137

NPI assigned

Apr 3, 2021

Last updated

Apr 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Tammie T Barksdale

Title

Owner/Administrator

Phone

(478) 257-7136

Specialties & licenses 1

Addresses

Other names 1

• Angels Divine Personal Care Home Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1617408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617408000000",
    "number": "1033798525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3065 JEFFERSONVILLE RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312175117",
            "telephone_number": "478-257-7136",
            "fax_number": "478-257-7137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 JEFFERSONVILLE RD",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312175117",
            "telephone_number": "478-257-7136",
            "fax_number": "478-257-7137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELS AT DIVINE RETREAT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-03",
        "last_updated": "2021-04-03",
        "certification_date": "2021-04-03",
        "status": "A",
        "authorized_official_last_name": "BARKSDALE",
        "authorized_official_first_name": "TAMMIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "478-257-7136",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "angelsdivinepch.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Direct Mail",
            "address_1": "3065 Jeffersonville Rd",
            "city": "Macon",
            "state": "GA",
            "country_code": "US",
            "postal_code": "312175117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Angels Divine Personal Care Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Roberta H Andrews, M.D.
• Anesthesia Associates of Macon LLP
• Anesthesiology Associates of America LLC
• Eduardo Angel, M.D.
• Angelic Hearts Home Care LLC
• Angels Corner LL (Angels Corner l)
• Angels of Mercy Private Homecare Services, Inc.
• Nathan Wade Anisko
• Isaac B Annan, MD
• Aqela Ansari

• Assisted Living Facility in Macon, GA
• Providers in Macon, 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 Apr 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.