Organization
ASSISTED LIVING CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDA SMITH (CFO)
(912) 354-3680
Entity
Organization
Contact information
Practice address
340 EISENHOWER DR, SUITE 1311, SAVANNAH, GA 31406-1600
(912) 354-3680
Mailing address
PO BOX 13664, SAVANNAH, GA 31416-0664
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000750252E
—
GA
Enumeration date
03/12/2012
Last updated
03/12/2012
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