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Organization
ANGELS AT DIVINE RETREAT LLC
Active
Organization
ANGELS AT DIVINE RETREAT LLC
Active
Other names
Angels Divine Personal Care Home
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMMIE T BARKSDALE (OWNER/ADMINISTRATOR)
(478) 257-7136
Entity
Organization
Contact information
Practice address
3065 JEFFERSONVILLE RD, MACON, GA 31217-5117
(478) 257-7136
(478) 257-7137
Mailing address
3065 JEFFERSONVILLE RD, MACON, GA 31217-5117
(478) 257-7136
(478) 257-7137
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/03/2021
Last updated
04/03/2021
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