Organization
SPAIN PERSONAL CARE HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CAROL P SPAIN (ADMINISTRATOR)
(478) 788-0771
Entity
Organization
Contact information
Practice address
3075 ANTIOCH RD, MACON, GA 31206-1545
(478) 788-0771
(866) 228-4859
Mailing address
3075 ANTIOCH RD, MACON, GA 31206-3381
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
GA
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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