# COUNTRY GARDENS LANIER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518462076
- **Authorized official:** MRS. CHRISTINA L TRENTHAM (VP OF OPERATIONS)
- **Authorized official phone:** (865) 293-6563

## Contact information

- **Practice address:** 255 ELM STREET, CUMMING, GA 30040
- **Practice address phone:** (770) 889-7889
- **Practice address fax:** (770) 886-5545
- **Mailing address:** 255 ELM STREET, CUMMING, GA 30040
- **Mailing address phone:** (770) 889-7889
- **Mailing address fax:** (770) 886-5545

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | PCH009162 | GA | Yes |

## Other

- **Enumeration date:** 03/27/2018
- **Last updated:** 03/27/2018