Phenomenal Living LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

PHENOMENAL LIVING LLC

Practice address

2410 Bon Air Dr
Savannah, GA 31406-2908

Phone

(912) 328-7679

Fax

(912) 234-0493

NPI assigned

Jul 24, 2018

Last updated

Dec 17, 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

Mrs. Jeraldine Geneva Love, CERTIFIED NURSING AS

Title

Owner

Phone

(912) 436-5110

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608163200000",
    "number": "1679050454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 BON AIR DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062908",
            "telephone_number": "912-328-7679",
            "fax_number": "912-234-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 BON AIR DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062908",
            "telephone_number": "912-328-7679",
            "fax_number": "912-234-0493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "604 South St.",
            "address_2": "604 South St",
            "address_purpose": "LOCATION",
            "city": "Savannah",
            "state": "GA",
            "postal_code": "31405",
            "country_code": "US",
            "telephone_number": "912-436-5110",
            "fax_number": "912-234-0493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHENOMENAL LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-24",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A",
        "authorized_official_last_name": "LOVE",
        "authorized_official_first_name": "JERALDINE",
        "authorized_official_middle_name": "GENEVA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-436-5110",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CERTIFIED NURSING AS"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": "GA",
            "license": "CN0012346961",
            "primary": false
        },
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Huy Pham
• Minh Thu Nguyen Pham, PHARMD
• Thy Pham, RPH
• Claude J Phan, PHARM.D.
• Jessica Phelps, DMD
• Thomas Herbert Philbrick, M.D.
• Philip I. Friedman, D.D.S., P.C.
• Alan Keane Phillips, CRNA
• Cary Phillips
• Cynthia Phillips

• Assisted Living Facility (Mental Illness) in Savannah, GA
• Providers in Savannah, 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 Dec 17, 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.