Organization
SENIOR LIVING AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHANNA LATOYA SENIOR (OWNER)
(229) 515-6113
Entity
Organization
Contact information
Practice address
414 N WEST ST, BAINBRIDGE, GA 39817-3678
(229) 515-6113
(229) 299-8689
Mailing address
414 N WEST ST, BAINBRIDGE, GA 39817-3678
(229) 515-6113
(229) 299-8689
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
06/25/2014
Last updated
06/25/2014
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