Growth Bridge Sparks PCH LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

GROWTH BRIDGE SPARKS PCH LLC

Practice address

204 S Goodman St
Sparks, GA 31647-7549

Phone

(229) 234-9775

NPI assigned

Sep 10, 2026

Last updated

Sep 10, 2026By 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

Leslie Ofori, MD

Title

Administrator

Phone

(770) 568-3923

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1788998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1902716145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3116 HOLLY MILL RUN",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300625460",
            "telephone_number": "770-609-7610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S GOODMAN ST",
            "city": "SPARKS",
            "state": "GA",
            "postal_code": "316477549",
            "telephone_number": "229-234-9775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROWTH BRIDGE SPARKS PCH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-10",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "OFORI",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-568-3923",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Sparks, GA
• Providers in Sparks, 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 Sep 10, 2026; 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.