Renaissance Gainesville 1, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

RENAISSANCE GAINESVILLE 1, LLC

Doing business as

Amber Glen Personal/Memory Care

Practice address

2215 Old Hamilton PL
Gainesville, GA 30507-7893

Phone

(470) 691-0161

Fax

(770) 297-1104

NPI assigned

Aug 28, 2020

Last updated

Aug 28, 2020By 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

Kathy Bellande

Title

Management Agent

Phone

(502) 228-8131

Specialties & licenses 1

Addresses

Other names 1

• Amber Glen Personal/Memory Care Doing business as

Locations

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598572800000",
    "number": "1225641368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12933 W HIGHWAY 42",
            "city": "PROSPECT",
            "state": "KY",
            "postal_code": "400599107",
            "telephone_number": "502-228-8131",
            "fax_number": "502-228-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 OLD HAMILTON PL",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305077893",
            "telephone_number": "470-691-0161",
            "fax_number": "770-297-1104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE GAINESVILLE 1, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-27",
        "status": "A",
        "authorized_official_last_name": "BELLANDE",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "MANAGEMENT AGENT",
        "authorized_official_telephone_number": "502-228-8131"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amber Glen Personal/Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joan Reid-Sievenpiper
• Joan Charlene Reilly, PHARM.D.
• Melanie Reilly, CCC-SLP
• Andrew Bradley Reisman, MD
• Rejuvia House
• Renal Care Group Gainesville East, LLC (RCG Gainesville)
• Renal Care Group Gainesville, LLC (RCG Lake Lanier)
• Renal Treatment Centers Mid Atlantic Inc (Gainesville Dialysis)
• Laurice Dawn Repke
• Kristina Reus, PA

• Assisted Living Facility in Gainesville, GA
• Providers in Gainesville, 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 Aug 28, 2020; 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.