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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