Leisure Life Care Home Inc
Organization Active NPI Assisted Living Facility · Unadilla, GA
NPI 1811032030 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1811032030
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- Legal business name
- LEISURE LIFE CARE HOME INC
- Practice address
- 301 Beacham Street
Unadilla, GA 31091 - Phone
- (478) 892-2058
- Fax
- (478) 892-2058
- NPI assigned
- Feb 21, 2007
- Organization subpart
- No
Authorized official
- Name
- Dora Watson
- Title
- Pres
- Phone
- (478) 892-2058
National Provider Directory
Locations
301 Beacham Ave
Unadilla, GA 31091
Phone (478) 627-9022
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | GA | Yes |
Addresses
Primary practice location
301 Beacham Street
Unadilla, GA 31091
Mailing address
PO Box 568
Hawkinsville, GA 31036
Phone (478) 892-2058
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00535477A | Medicaid | GA |
Other providers in Unadilla, GA
- Healthcare of Unadilla LLC
- Alicia Henderson
- Alexander Chukwuma Ibezi-Enendu
- Kimberly Crump Johnson
- Kristie Lashawn Lawson
- Malozera Primary Care, LLC
- Laquish Denise Martin
- Bianca Lester McBurse
- McMahan Pharmacy, Inc
- Dhara Patel
All providers in Unadilla, GA · Assisted Living 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 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.