Family Life Enrichment Center, Inc.
Organization Active NPI Skilled Nursing Facility · High Shoals, GA
NPI 1720125552 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1720125552
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 1-108-942 (GA)
- Legal business name
- FAMILY LIFE ENRICHMENT CENTER, INC.
- Practice address
- 3450 New High Shoals Road
High Shoals, GA 30645-0001 - Phone
- (706) 769-7738
- Fax
- (706) 769-5944
- NPI assigned
- Jan 31, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. Joseph R. Bennett, II, MSED.
- Title
- Assistant Administrator
- Phone
- (706) 769-7738
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 1-108-942 | GA | Yes |
Addresses
Primary practice location
3450 New High Shoals Road
High Shoals, GA 30645-0001
Mailing address
3450 New High Shoals Road
High Shoals, GA 30645-0001
Phone (706) 769-7738
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00212814A | Medicaid | GA |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 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.