Traces of Tiger I

Organization Active NPI Assisted Living Facility · Tiger, GA

NPI 1770036030 · NPPES record last updated Aug 3, 2016

Key facts

NPI
1770036030
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility 310400000X
License
119030011 (GA)
Legal business name
TRACES OF TIGER I
Practice address
382 Bridge Creek Rd
Tiger, GA 30576-2211
Phone
(706) 782-6208
Fax
(706) 782-5019
NPI assigned
Aug 3, 2016
Organization subpart
No

Authorized official

Name
Ms. Carlie S Pennington
Title
Sole MB
Phone
(706) 746-6571

National Provider Directory

Locations

382 Bridge Creek Rd
Tiger, GA 30576
Phone (706) 782-6208

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 119030011 GA Yes

Addresses

Primary practice location

382 Bridge Creek Rd
Tiger, GA 30576-2211

Mailing address

382 Bridge Creek Rd
Tiger, GA 30576-2211
Phone (706) 782-6208

Other providers in Tiger, GA

All providers in Tiger, GA · Assisted Living Facility in Georgia

Sources for this page

Verify at the official NPI Registry.