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

Sid's Place Incorporated

Organization Assisted Living Facility · NPI 1174823595

Sid's Place Incorporated is an Assisted Living Facility in Ellenwood, Georgia. Licensed in Georgia. Registered with an NPI since 2010.

Licensed in
GA
In the registry since
2010
Specialties on file
2

Practice location Address checks out

2742 Luke Dr
Ellenwood, GA 30294-3987
Phone: (678) 557-8969
Fax: (404) 521-4888
Show map & directions

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

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X · Licence 031012928 (GA)
Mental Illness Community Based Residential Treatment Facility Taxonomy 320800000X · Licence 031012928 (GA)

Record details

NPI number1174823595
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Zannie Black — Owner · (678) 557-8969
NPI enumeratedNovember 1, 2010
Last updated in NPPESNovember 1, 2010
Mailing address2742 Luke Dr, Ellenwood, GA 30294-3987

Other providers in Ellenwood