Organization
MILDRED'S HOMEPLACE III
Active
Organization
MILDRED'S HOMEPLACE III
Active
Other names
The HomePlace Shelter Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY LEE MITCHELL (ADMINISTRATOR)
(229) 228-1985
Entity
Organization
Contact information
Practice address
357 A & B SHORELINE DRIVE, THOMASVILLE, GA 31792-4608
(229) 551-0695
(229) 551-0694
Mailing address
612 EAST CLAY STREET, THOMASVILLE, GA 31792-4608
(229) 551-0695
(229) 551-0694
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
GA
343900000X
Non-emergency Medical Transport (VAN)
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
136-01-096-1
PERSONALCARE HOME
GA
Enumeration date
09/29/2009
Last updated
09/29/2009
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