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PROVIDENCE PLACE LLC
NPI 1063132876
Assisted Living Facility in Jesup, GA

Active since August 31, 2022
249 JOE NAIA RD, JESUP, GA 31545(912) 415-1313 Get Directions Write a Review

NPPES record last updated: August 31, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Providence Place Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE PLACE LLC (NPI 1063132876), doing business as Cotton Grove Estate, is a healthcare organization registered as an assisted living facility in Jesup, Georgia and active in the NPI registry since August 2022. The organization lists Stephanie Chadwick, Owner, as its authorized official.

NPPES Registry Identity

NPI1063132876
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePROVIDENCE PLACE LLC
Location Address249 JOE NAIA RDJesup, GA 31545-4112
Mailing Address249 Joe Naia RdJesup, GA 31545-4112 · (912) 415-1313
Phone(912) 415-1313
Organization SubpartYes
Authorized OfficialStephanie ChadwickOwner · (912) 415-1313
Enumeration DateAugust 31, 2022
NPPES CertifiedAugust 31, 2022
✔ NPI 1063132876 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
Also ListedDay Training, Developmentally Disabled ServicesTaxonomy 251C00000X
Also ListedResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesTaxonomy 320600000X
249 JOE NAIA RD, Jesup, GA 31545
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Other Names 1

Doing Business AsCotton Grove Estate

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Providence Place LLC's NPI number?

The NPI number for Providence Place LLC is 1063132876. It was assigned to this organization in the NPPES registry on August 31, 2022. The provider is doing business as Cotton Grove Estate.

Where is Providence Place LLC located?

Providence Place LLC is located at 249 Joe Naia Rd, Jesup, GA 31545. The listed phone number is (912) 415-1313.

What is Providence Place LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Providence Place LLC was last updated on August 31, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.