Organization
QUALITY CHOICE PCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL P SPAIN (ADMINISTRATOR)
(478) 319-0678
Entity
Organization
Contact information
Practice address
3075 ANTIOCH RD, MACON, GA 31206-1545
(478) 788-0771
Mailing address
PO BOX 3381, MACON, GA 31205-3381
(478) 788-0771
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000455793A
—
GA
Enumeration date
10/09/2013
Last updated
10/09/2013
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