Thomasville I Enterprises, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

THOMASVILLE I ENTERPRISES, LLC

Doing business as

Plantation Manor

Practice address

220 Park Ave
Thomasville, GA 31792-6145

Phone

(229) 227-0880

Fax

(229) 227-1217

NPI assigned

Jun 18, 2010

Organization subpart

No

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

Authorized official

Name

Gary Blake

Title

Managing Member

Phone

(817) 348-8841

Specialties & licenses 1

Addresses

Other names 1

• Plantation Manor Doing business as

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

{
    "created_epoch": "1276819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276819200000",
    "number": "1114248663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 PARK AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926145",
            "telephone_number": "229-227-0880",
            "fax_number": "229-227-1217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 PARK AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926145",
            "telephone_number": "229-227-0880",
            "fax_number": "229-227-1217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMASVILLE I ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-18",
        "last_updated": "2010-06-18",
        "status": "A",
        "authorized_official_last_name": "BLAKE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "817-348-8841"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plantation Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Thomasville, GA
• Providers in Thomasville, 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 Jun 18, 2010; 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.