NPI age
15 years
Enumerated 2010-11-01
● Active Type 2 · Organization
Sid'S Place Incorporated
Sid'S Place Incorporated is 1 of 519 assisted living facility organizations in Georgia.
Primary specialty
Assisted Living Facility
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Black
Owner
Last NPPES update
2010-11-01
Source: monthly bulk 2026-05
How this organization compares
Across 519 active assisted living facility providers in Georgia.
NPI age
15 years
↑ 3 yr above median
Practice locations
1
0 secondary on file
Subspecialties
1
In the 11% of peers with subspecialties
NPI lifetime · 2010 → 2026
2010-11Enumerated in NPPES
2010
2026
Where they practice
Primary practice location
2742 Luke Dr
Ellenwood, GA 302943987
Mailing address
2742 Luke Dr
Ellenwood, GA 302943987
Authorized official
Zannie Darrell Black
Owner
📞 6785578969
Specialties
-
Assisted Living Facility PrimaryA 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.
-
Community Based Residential Treatment Facility, Mental IllnessA home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 992605365A |
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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