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Organization
GLASCOCK COUNTY HEALTH CARE LLC
Active
Organization
GLASCOCK COUNTY HEALTH CARE LLC
Active
Other names
The Southern Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMIE STEWART (ADMINISTRATOR)
(706) 598-2167
Entity
Organization
Contact information
Practice address
434 BEALL SPRINGS RD, GIBSON, GA 30810-4224
(706) 598-2167
(706) 598-3802
Mailing address
PO BOX 248, GIBSON, GA 30810-0248
(706) 598-2167
(706) 598-3802
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
062-02-001-1
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000258706A
—
GA
Enumeration date
09/09/2005
Last updated
05/24/2011
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