Lillian Womble
Individual provider Active NPI Adult Care Home Facility · Warthen, GA
NPI 1023615531 · NPPES record last updated Oct 7, 2020
Key facts
- NPI
- 1023615531
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Care Home Facility 311ZA0620X
- Practice address
- 3232 Union Church Road
Warthen, GA 31094 - Phone
- (478) 363-9381
- NPI assigned
- Oct 7, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Care Home Facility | 311ZA0620X | Yes |
Addresses
Primary practice location
3232 Union Church Road
Warthen, GA 31094
Mailing address
3232 Union Church Road
Warthen, GA 31094
Phone (478) 363-9381
Other providers in Warthen, GA
All providers in Warthen, GA · Adult Care Home Facility in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 7, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.