Pendley Personal Care Home Inc.

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

LCB20050032910 Issued in GA

Legal business name

PENDLEY PERSONAL CARE HOME INC.

Practice address

2548 Central Ave
Augusta, GA 30904-6240

Phone

(706) 496-5884

NPI assigned

Sep 9, 2011

Organization subpart

No

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

Authorized official

Name

Ms. Kimberly Pendley

Title

Owner/Manager

Phone

(706) 496-5884

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1315526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315526400000",
    "number": "1447532007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3144",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309143144",
            "telephone_number": "706-496-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2548 CENTRAL AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046240",
            "telephone_number": "706-496-5884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENDLEY PERSONAL CARE HOME INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-09",
        "last_updated": "2011-09-09",
        "status": "A",
        "authorized_official_last_name": "PENDLEY",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "706-496-5884",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "GA",
            "license": "LCB20050032910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kasci Deanne Pelucarte, D.O.
• Michael Phillip Pence, D.O.
• Lilian Pencille, LCSW
• Robert Pendergrast Jr., MD
• Brooks Edward Pendleton, PT, DPT
• James Walker Penland Jr., COTA/L
• Penn Heart LLC
• Penn Teck Diagnostics Inc
• Jaime Penn
• Clayton William Pennington, M.D.

• Assisted Living Facility (Mental Illness) in Augusta, GA
• Providers in Augusta, GA by specialty
• Assisted Living Facility (Mental Illness) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2011; 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.