OrganizationActive
Provident Group - Creekside Properties LLC
NPI 1891287645 · Assisted Living Facility · Smyrna, GA
Provider details
- NPI number
- 1891287645
- Entity type
- Organization
- Primary specialty
- Assisted Living FacilityNursing & Custodial Care Facilities
- Organization subpart
- No
- Authorized official
- Debra Lockwood, President & Chief Financial Officer(225) 766-3977
Specialties & taxonomies
Nursing & Custodial Care Facilities
- Alzheimer Center (Dementia Center)311500000X
Nursing & Custodial Care Facilities
- Respite Care385H00000X
Respite Care Facility
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4838 South Cobb Drive
Smyrna, GA 30080
Phone: (678) 710-1834
Fax: (678) 236-0374
Street-level locationGet directions
Mailing address
5565 Bankers Avenue
Baton Rouge, LA 70808
Other names (DBA / former)
- Doing business as
- Provident Village at Creekside
Registry dates
- Enumerated
- 2018-06-06
- Last updated
- 2018-06-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.