Glascock County Health Care LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

062-02-001-1 Issued in GA

Legal business name

GLASCOCK COUNTY HEALTH CARE LLC

Doing business as

The Southern Living Center

Practice address

434 Beall Springs Rd
Gibson, GA 30810-4224

Phone

(706) 598-2167

Fax

(706) 598-3802

NPI assigned

Sep 9, 2005

Last updated

May 24, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jimmie Stewart

Title

Administrator

Phone

(706) 598-2167

Specialties & licenses 1

Addresses

Other names 1

• The Southern Living Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1487648010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 248",
            "city": "GIBSON",
            "state": "GA",
            "postal_code": "308100248",
            "telephone_number": "706-598-2167",
            "fax_number": "706-598-3802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 BEALL SPRINGS RD",
            "city": "GIBSON",
            "state": "GA",
            "postal_code": "308104224",
            "telephone_number": "706-598-2167",
            "fax_number": "706-598-3802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLASCOCK COUNTY HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-09",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "JIMMIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "706-598-2167"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "GA",
            "license": "062-02-001-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Southern Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Doriann Dye
• Gibson Health Opco LLC
• Glascock County Board of Health (Glascock County Health Department)
• Glascock County Board of Health (Glascock County Health Deartment)
• Glascock County Boe
• Glascock County Health Care LLC (Gibson Health and Rehabilitation)
• Nona Joe Lord, RN, BSN
• Holly Lynn Stewart, FNP-C
• Debbie B Williford, LMT

• Assisted Living Facility in Gibson, GA
• Providers in Gibson, GA by specialty
• Assisted Living Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.