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PHENOMENAL LIVING LLC NPI 1679050454


NPI Information

NPI: 1679050454
Provider Name: PHENOMENAL LIVING LLC
Classification: Assisted Living Facility - 3104A0625X
Entity Type: Organization

Specialization: Assisted Living, Mental Illness

Address:
2410 BON AIR DR
SAVANNAH, GA
ZIP 31406
Phone: (912) 328-7679
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PHENOMENAL LIVING LLC is an assisted living and mental illness assisted living facility in Savannah, GA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. PHENOMENAL LIVING LLC NPI is 1679050454. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2410 BON AIR DR
SAVANNAH, GA
ZIP 31406-908
Phone: (912) 328-7679
Fax: (912) 234-0493

The provider's authorized official is Jeraldine Geneva Love .
The authorized official title is Owner and has the following contact phone number (912) 436-5110.

The enumeration date for this NPI number is 7/24/2018 and was last updated on 12/17/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1163WH0200XRegistered NurseHome HealthCN0012346961GEORGIANo
23104A0625XAssisted Living FacilityAssisted Living, Mental IllnessYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.