Organization
SOUTH DOOLEY RETIREMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DORIS ELLIS KELLEY M.S. (ADMINISTRATOR)
(478) 783-4117
Entity
Organization
Contact information
Practice address
105 S DOOLEY ST, 105 SOUTH DOOLEY STREET, HAWKINSVILLE, GA 31036-1703
(478) 783-4117
Mailing address
105 SOUTH DOOLEY STREET, HAWKINSVILLE, GA 31036
(478) 783-4117
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
968169651A
—
GA
05
—
968169651B
—
GA
Enumeration date
07/17/2008
Last updated
07/17/2008
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