Stilesboro Personal Care Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

STILESBORO PERSONAL CARE HOME LLC

Doing business as

Stilesboro Assisted Living

Practice address

4549 Stilesboro Rd NW
Kennesaw, GA 30152-3945

Phone

(678) 290-0085

Fax

(888) 540-0201

NPI assigned

Jun 24, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Garfield McCook, BS

Title

Owner

Phone

(678) 778-6335

Specialties & licenses 3

Addresses

Other names 1

• Stilesboro Assisted Living Doing business as

Locations

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592956800000",
    "number": "1275159386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4549 STILESBORO RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523945",
            "telephone_number": "678-290-0085",
            "fax_number": "888-540-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4549 STILESBORO RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301523945",
            "telephone_number": "678-290-0085",
            "fax_number": "888-540-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STILESBORO PERSONAL CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A",
        "authorized_official_last_name": "MCCOOK",
        "authorized_official_first_name": "GARFIELD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-778-6335",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stilesboro Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keith A Stevens, D.C.
• Mark G Stevens, PT
• Deanna Stewart, MD
• Tamu T Stewart, CNA
• Ingrid Stier, NP
• James Bryan Stinchcomb, MSW, HS-BCP
• Ebony Stinson, LPC
• Karyn Lynn Stockwell, D.M.D.
• Tashawna Thomas Stokes, MD
• Stone Family Chiropractic Center

• Assisted Living Facility in Kennesaw, GA
• Providers in Kennesaw, 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 24, 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.