JBKT Enterprises, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

PCH009212 Issued in GA

Legal business name

JBKT ENTERPRISES, LLC

Doing business as

The Rachel House

Practice address

204 W Colquitt St
Sparks, GA 31647-7602

Phone

(229) 549-6100

NPI assigned

Jul 25, 2017

Last updated

Jun 16, 2018By 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

Jon Penuel

Title

Owner

Phone

(229) 549-6100

Specialties & licenses 1

Addresses

Other names 1

• The Rachel House Doing business as

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1225551906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155",
            "city": "SPARKS",
            "state": "GA",
            "postal_code": "316470155",
            "telephone_number": "229-549-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W COLQUITT ST",
            "city": "SPARKS",
            "state": "GA",
            "postal_code": "316477602",
            "telephone_number": "229-549-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JBKT ENTERPRISES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-25",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "PENUEL",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-549-6100"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "PCH009212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Rachel House",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanya Lashon Cornelius
• Growth Bridge Sparks PCH LLC
• Priscilla Os Hernandez
• Sandra Holloway
• Adrian Johnson, RN
• Kayse Deann Layfield
• Jessica Pope
• Rachel House,Inc
• Serenity Assisted Living LLC (Serenity)

• Assisted Living Facility in Sparks, GA
• Providers in Sparks, 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 16, 2018; 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.