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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