Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brandon Wilde LLC

Organization Assisted Living Facility · NPI 1780450924

Brandon Wilde LLC is an Assisted Living Facility in Evans, Georgia. Registered with an NPI since 2023.

In the registry since
2023
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

4275 Owens Rd
Evans, GA 30809-3066
Phone: (706) 868-3568
Fax: (706) 868-3525
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X
Assisted Living Facility Taxonomy 310400000X

Record details

NPI number1780450924
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jason Victor — Sr. Vp And Treasurer · (515) 875-4619
Other names The Pavilion At Brandon Wilde
NPI enumeratedNovember 29, 2023
Last updated in NPPESNovember 29, 2023
Certification dateNovember 29, 2023
Mailing address4275 Owens Rd, Evans, GA 30809-3066

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