Telesha Harris
Individual provider Active NPI Adult Care Home Facility · Warthen, GA
NPI 1700540424 · NPPES record last updated Oct 28, 2021
Key facts
- NPI
- 1700540424
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Care Home Facility 311ZA0620X
- Practice address
- 3232 Union Church Rd
Warthen, GA 31094-3109 - Phone
- (478) 357-8777
- NPI assigned
- Oct 28, 2021
- 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 | GA | Yes |
Addresses
Primary practice location
3232 Union Church Rd
Warthen, GA 31094-3109
Mailing address
1056 S Confederate Dr
Macon, GA 31220-2829
Phone (478) 357-8777
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 28, 2021. 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.