Organization
LAKE OCONEE ASSISTED LIVING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LILLIE R TRIPP (OWNER)
(706) 453-9055
Entity
Organization
Contact information
Practice address
105 WILSON ST, GREENSBORO, GA 30642-1426
(706) 453-7155
(706) 453-4156
Mailing address
PO BOX 1152, 105 WILSON STREET, GREENSBORO, GA 30642-8152
(706) 453-7155
(706) 453-4156
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
06/14/2007
Last updated
08/22/2020
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