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Organization
MONTEZUMA HEALTH CARE CENTER LLC
Active
Organization
MONTEZUMA HEALTH CARE CENTER LLC
Active
Other names
Montezuma Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE CRISP (ADMINISTRATOR)
(478) 472-8168
Entity
Organization
Contact information
Practice address
506 SUMTER ST, MONTEZUMA, GA 31063-1734
(478) 472-8168
(478) 472-2373
Mailing address
PO BOX 639, MONTEZUMA, GA 31063-0639
(478) 472-8168
(478) 472-2373
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
1-094-1731
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287282627D
—
GA
Enumeration date
07/24/2006
Last updated
06/24/2008
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