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

Providence Place LLC

Organization Developmentally Disabled Services Day Training Agency · NPI 1063132876

Providence Place LLC is a Developmentally Disabled Services Day Training Agency in Jesup, Georgia. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
3
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

249 Joe Naia Rd
Jesup, GA 31545-4112
Phone: (912) 415-1313
Show map & directions

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

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X
Developmentally Disabled Services Day Training Agency Taxonomy 251C00000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility Taxonomy 320600000X

Record details

NPI number1063132876
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Place LLC
Authorized official Stephanie Chadwick — Owner · (912) 415-1313
Other names Cotton Grove Estate
NPI enumeratedAugust 31, 2022
Last updated in NPPESAugust 31, 2022
Certification dateAugust 31, 2022
Mailing address249 Joe Naia Rd, Jesup, GA 31545-4112