WILLIE B GARDNER ASSISTED LIVING INC.
NPI 1710683396
Assisted Living Facility in Riverdale, GA

Q: What is Willie B Gardner Assisted Living Inc.'s specialty?

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

Active since February 06, 2023

1262 KING RD, RIVERDALE, GA 30296(678) 789-5174 Get Directions Write a Review

NPPES record last updated: February 6, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Willie B Gardner Assisted Living Inc. NPPES

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

WILLIE B GARDNER ASSISTED LIVING INC. (NPI 1710683396), doing business as Willie B Gardner Care Home Inc., is a healthcare organization registered as an assisted living facility in Riverdale, Georgia and active in the NPI registry since February 2023. The organization lists Shaurina S. Dudley, Ceo, as its authorized official.

NPPES Registry Identity

NPI1710683396

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameWILLIE B GARDNER ASSISTED LIVING INC.

Location Address1262 KING RDRiverdale, GA 30296-2952

Mailing Address1262 King RdRiverdale, GA 30296-2952 · (678) 789-5174

Phone(678) 789-5174

Organization SubpartNo

Authorized OfficialShaurina S. DudleyCeo · (678) 663-9674

Enumeration DateFebruary 6, 2023

NPPES CertifiedFebruary 4, 2023

✔ NPI 1710683396 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.

1262 KING RD, Riverdale, GA 30296

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Other Names 1

Doing Business AsWillie B Gardner Care Home Inc.

Other Providers at the Same Location NPPES

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

NEW WAY CARE HOME INC

Residential Treatment Facility, Physical Disabilities

1262 KING RD
RIVERDALE, GA 30296

Clayton County (770) 573-4788

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 Willie B Gardner Assisted Living Inc.'s NPI number?

The NPI number for Willie B Gardner Assisted Living Inc. is 1710683396. It was assigned to this organization in the NPPES registry on February 6, 2023. The provider is doing business as Willie B Gardner Care Home Inc..

Where is Willie B Gardner Assisted Living Inc. located?

Willie B Gardner Assisted Living Inc. is located at 1262 King Rd, Riverdale, GA 30296. The listed phone number is (678) 789-5174.

What is Willie B Gardner Assisted Living Inc.'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 Willie B Gardner Assisted Living Inc. was last updated on February 6, 2023. 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.