Majestic Senior Living Tennille LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MAJESTIC SENIOR LIVING TENNILLE LLC

Doing business as

Majestic Senior Living Tennille

Practice address

401 Martin Luther King Jr Blvd
Tennille, GA 31089-1438

Phone

(478) 552-8881

NPI assigned

Nov 3, 2017

Last updated

Nov 3, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

MAJESTIC SENIOR LIVING, LLCAs reported in NPPES

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

Authorized official

Name

Bruce Abdon

Title

President

Phone

(352) 222-0417

Specialties & licenses 1

Addresses

Other names 1

• Majestic Senior Living Tennille Doing business as

Locations

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509667200000",
    "number": "1689186223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2451 CUMBERLAND PKWY SE STE 3560",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303396136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MARTIN LUTHER KING JR BLVD",
            "city": "TENNILLE",
            "state": "GA",
            "postal_code": "310891438",
            "telephone_number": "478-552-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAJESTIC SENIOR LIVING TENNILLE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAJESTIC SENIOR LIVING, LLC",
        "enumeration_date": "2017-11-03",
        "last_updated": "2017-11-03",
        "status": "A",
        "authorized_official_last_name": "ABDON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-222-0417"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Majestic Senior Living Tennille",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanya Yvonne Jones, M.D.
• Jada Breyle Jordan
• Ramekia N Jordan
• Lisa G Lamar, CERTIFIEDHHHIDE
• Little Behaviors LLC
• Stephanie T McBurrough, FNP-C
• Nicks Nemt
• Jane Paulk, FNP-BC
• Debbie Pierce Price
• Temeka Reese, LMSW

• Assisted Living Facility in Tennille, GA
• Providers in Tennille, 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 Nov 3, 2017; 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.