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PRUITTPLACE - BUCKHEAD, LLC
NPI 1083476105
Assisted Living Facility in Atlanta, GA

Active since January 24, 2024CLIA Certified · 2 labs
3088 LENOX RD NE, ATLANTA, GA 30324(770) 279-6200 Get Directions Write a Review

NPPES record last updated: June 13, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Pruittplace - Buckhead, Llc NPPES

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

PRUITTPLACE - BUCKHEAD, LLC (NPI 1083476105) is a healthcare organization registered as an assisted living facility in Atlanta, Georgia and active in the NPI registry since January 2024. The organization holds 2 active CLIA laboratory certificates and lists Neil L Pruitt, Chairman And Ceo, as its authorized official.

NPPES Registry Identity

NPI1083476105
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePRUITTPLACE - BUCKHEAD, LLC
Location Address3088 LENOX RD NEAtlanta, GA 30324-2894
Mailing Address1626 Jeurgens CtNorcross, GA 30093-2219 · (770) 279-6200
Phone(770) 279-6200
Organization SubpartNo
Authorized OfficialNeil L PruittChairman And Ceo · (770) 279-6200
Enumeration DateJanuary 24, 2024
Last NPPES UpdateJune 13, 2024
NPPES CertifiedJune 13, 2024
✔ NPI 1083476105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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 ListedClinic/Center · RehabilitationTaxonomy 261QR0400X
3088 LENOX RD NE, Atlanta, GA 30324
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CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2299511

Pruittplace Buckhead, LLC Dba Pruittplace- Buckhead · Atlanta, GA
Active · expires Feb 21, 2028
CLIA Number11D2299511
Laboratory TypeAssisted Living Facility
Certificate Effective DateFebruary 22, 2026
Certificate Expiration DateFebruary 21, 2028
Laboratory DirectorMark Raben
Laboratory Phone(770) 279-6200
Laboratory LocationPruittplace Buckhead, LLC Dba Pruittplace- Buckhead3088 Lenox Road NE, Atlanta, GA 30324
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 11D2321172

Pruittplace Kennesaw, LLC · Kennesaw, GA
Active · expires Mar 30, 2027
CLIA Number11D2321172
Laboratory TypeAssisted Living Facility
Certificate Effective DateMarch 31, 2025
Certificate Expiration DateMarch 30, 2027
Laboratory DirectorIvana Drew
Laboratory Phone(770) 279-6200
Laboratory LocationPruittplace Kennesaw, LLC5235 Stilesboro Road, NW, Kennesaw, GA 30152
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. TERRY CRAVENS JR. COTA
Occupational Therapy Assistant
3088 LENOX RD NE
ATLANTA, GA 30324
Fulton County (404) 846-8335
ALLISON LANE GOWENS OTR/L
Occupational Therapist
3088 LENOX RD NE
ATLANTA, GA 30324
Fulton County (404) 816-3991
MRS. LATONYA MICHELLE ANDREWS COTA L
Occupational Therapy Assistant
3088 LENOX RD NE
ATLANTA, GA 30324
Fulton County (404) 816-3991
THEODORE JEURDON HOWARD PTA
Physical Therapy Assistant
3088 LENOX RD NE
ATLANTA, GA 30324
Fulton County (404) 816-3991
ALICIA BRIA COTA/L
Occupational Therapy Assistant
3088 LENOX RD NE
ATLANTA, GA 30324
Fulton County (706) 414-9466
TIFFANY VILLA PTA
Physical Therapy Assistant
3088 LENOX RD NE
ATLANTA, GA 30324
Fulton County (404) 816-3991
KRISTEN HARTLEY
Physical Therapy Assistant
3088 LENOX RD NE
ATLANTA, GA 30324
Fulton County (404) 816-3991
ALEXANDRA BRANDT
Physical Therapist
3088 LENOX RD NE
ATLANTA, GA 30324
Fulton County (404) 846-8335

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 Pruittplace - Buckhead, LLC's NPI number?

The NPI number for Pruittplace - Buckhead, LLC is 1083476105. It was assigned to this organization in the NPPES registry on January 24, 2024.

Where is Pruittplace - Buckhead, LLC located?

Pruittplace - Buckhead, LLC is located at 3088 Lenox Rd NE, Atlanta, GA 30324. The listed phone number is (770) 279-6200.

What is Pruittplace - Buckhead, LLC's specialty?

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

Does Pruittplace - Buckhead, LLC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Pruittplace - Buckhead, LLC was last updated on June 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.