NPIMap

Organization Active NPI

Traditions Health and Rehabilitation Center LLC

  • Skilled Nursing Facility
  • Lithonia, GA
National Provider Identifier
1972549772
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
1-044-1789 Issued in GA
Legal business name
TRADITIONS HEALTH AND REHABILITATION CENTER LLC
Practice address
2816 Evans Mill Rd
Lithonia, GA 30058-7440
Phone
(770) 482-2961
Fax
(770) 484-8357
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Authorized official

Name
Soukhy Clark
Title
Administrator
Phone
(770) 482-2961

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 1-044-1789 GA Primary

Addresses

Primary practice location

2816 Evans Mill Rd
Lithonia, GA 30058-7440

Mailing address

PO Box 855
Lithonia, GA 30058-0855
Phone (770) 482-2961

Other identifiers 2

IdentifierTypeStateIssuer
510012120 001OtherBCBS
000143701AMedicaidGA

Other names 1

  • Traditions Health and Rehabilitation Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030801000003 GA Part A Provider - Skilled Nursing Facility 7012828700 Practice locations: Lithonia, GA

Skilled nursing facility certification: CCN 115473

Legal name
TRADITIONS HEALTH AND REHABILITATION CENTER LLC
Doing business as
TRADITIONS HEALTH AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 27, 1989
Last certification
Sep 5, 2024
Beds
150
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Pruitt Health
Most recent change of ownership
Dec 15, 2025
Organization structure
LLCNon-profit
Enrollment address
2816 Evans Mill Rd
Lithonia, GA 30058-7440

Care Compare: Nursing home

Medicare Care Compare
Listed as
PruittHealth - Lithonia, LLCCCN 115473
Overall star rating
3 of 5
Health inspections
3 of 5
Staffing
2 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Nov 27, 1989
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
150142.5 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Individual Adp of the SNF Jan 1, 2024
Paul a Cable Individual Managing Control - Governing BodyBoard Member Mar 14, 2003
Organization, Hawkinsville, GA Corporation, Medical provider/supplier, Non-profit Adp of the SNF Apr 21, 2025
Individual Adp of the SNF Jan 1, 2024
Ralph Parks Warnock Individual Managing Control - Governing Body Jun 23, 2020
Individual Adp of the SNF Jan 1, 2025
Organization, Gray, GA LLC, Medical provider/supplier, Non-profit Adp of the SNF Apr 21, 2025
Ronnie D Rollins Individual Managing Control - Governing BodyBoard Member Mar 14, 2003
Health Systems Real Estate, Inc Organization, Gray, GA Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Apr 1, 2014 100%
Adp of the SNF Jun 26, 2024
Organization, Gray, GA Corporation, Non-profit Adp of the SNF Jun 3, 2025
Reno D Lambert Individual Operational/Managerial Control Sep 1, 2023
Managing Control - Governing BodyDVP Sep 1, 2023
Kathryn Dennis Individual Managing Control - Governing BodyBoard Member Nov 17, 2015
Individual Adp of the SNF Dec 1, 2022
Clinical Services Inc Organization, Gray, GA Corporation, Management services company, Non-profit, Chain home office Operational/Managerial Control Mar 24, 2009
Adp of the SNF Jun 20, 2025
Community Health Systems Inc Organization, Macon, GA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Mar 24, 2009 100%
Shanathania Mahorn Individual Operational/Managerial Control May 16, 2025
Adp of the SNF Jun 3, 2025
Health Scholarships Inc Organization, Gray, GA Corporation, Holding company, Non-profit 5% Or Greater Direct Ownership Interest Mar 31, 2003 100%
Individual Adp of the SNF Sep 16, 2024
Agnes Ogoo Individual Operational/Managerial Control Apr 4, 2022
Individual Adp of the SNF Jan 1, 2025
Joseph a Wall Individual Managing Control - Governing BodyBoard Member Mar 14, 2003
Organization, Macon, GA LLC, Non-profit Adp of the SNF Apr 18, 2025
Joseph Nichols Individual Managing Control - Governing BodyBoard Member Nov 19, 2024

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 50

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 50

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695859200000",
    "number": "1972549772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 855",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300580855",
            "telephone_number": "770-482-2961",
            "fax_number": "770-484-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 EVANS MILL RD",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587440",
            "telephone_number": "770-482-2961",
            "fax_number": "770-484-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRADITIONS HEALTH AND REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SOUKHY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "770-482-2961"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "GA",
            "license": "1-044-1789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "510012120 001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000143701A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Traditions Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Traditions Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lithonia, GA

Sources for this page

Verify at the official NPI Registry.