THE PAVILION AT BRANDON WILDE
NPI 1821580440
Skilled Nursing Facility in Evans, GA

Active since May 30, 2018
4275 OWENS RD, EVANS, GA 30809(706) 868-9800 Get Directions Write a Review

NPPES record last updated: June 19, 2019. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 19, 2019, Aug 31, 2018 (2 updates tracked since 2018).

About The Pavilion At Brandon Wilde NPPES

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

THE PAVILION AT BRANDON WILDE (NPI 1821580440) is a healthcare organization registered as a skilled nursing facility in Evans, Georgia and active in the NPI registry since May 2018. The organization lists Diane C Bridgewater, Manager Of Managing Member, as its authorized official.

NPPES Registry Identity

NPI1821580440
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameLCS BRANDON WILDE LLC
Location Address4275 OWENS RDEvans, GA 30809
Mailing Address4275 Owens RdEvans, GA 30809-3066 · (706) 868-9800
Organization SubpartNo
Authorized OfficialDiane C BridgewaterManager Of Managing Member · (515) 875-4500
Enumeration DateMay 30, 2018
Last NPPES UpdateJune 19, 20192 updates tracked since enumeration
NPI 1821580440 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
License Licensed in GA · 1-036-2130
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Also ListedAssisted Living FacilityTaxonomy 310400000X
4275 OWENS RD, Evans, GA 30809

Other Names 1

Doing Business AsThe Pavilion At Brandon Wilde

Other Providers at the Same Location NPPES 4

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

Skilled Nursing Facility
4275 OWENS RD
EVANS, GA 30809
Skilled Nursing Facility
4275 OWENS RD
EVANS, GA 30809
Speech-Language Pathologist
4275 OWENS RD
EVANS, GA 30809
General Practice
4275 OWENS RD, APT. 518
EVANS, GA 30809

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 Lcs Brandon Wilde LLC's NPI number?

The NPI number for Lcs Brandon Wilde LLC is 1821580440. It was assigned to this organization in the NPPES registry on May 30, 2018. The provider is doing business as The Pavilion At Brandon Wilde.

Where is Lcs Brandon Wilde LLC located?

Lcs Brandon Wilde LLC is located at 4275 Owens Rd, Evans, GA 30809. The listed phone number is (706) 868-9800.

What is Lcs Brandon Wilde LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

When was this NPI record last updated?

The NPPES record for Lcs Brandon Wilde LLC was last updated on June 19, 2019. NPI Profile syncs with the weekly NPPES data releases published by CMS.