Georgia Dept of Human Resources

Organization Active NPI Intellectual Disabilities Intermediate Care Facility · Milledgeville, GA

NPI 1346353075 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1346353075
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual Disabilities Intermediate Care Facility 315P00000X
Legal business name
GEORGIA DEPT OF HUMAN RESOURCES
Practice address
171 Allen Rd
Milledgeville, GA 31062-7525
Phone
(478) 445-4128
NPI assigned
Aug 16, 2006
Organization subpart
No

Authorized official

Name
Mr. Marvin Bailey
Title
Regional Hospital Administrator
Phone
(478) 445-4128

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Roosevelt Warm SGP Inst (74 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Yes

Addresses

Primary practice location

171 Allen Rd
Milledgeville, GA 31062-7525

Mailing address

171 Allen Rd
Milledgeville, GA 31062-7525

Other identifiers

IdentifierTypeStateIssuer
00142414AMedicaidGA

Other names

  • Allen Hall Doing business as

Other providers in Milledgeville, GA

All providers in Milledgeville, GA · Intellectual Disabilities Intermediate Care Facility in Georgia

Sources for this page

Verify at the official NPI Registry.