Organization
MIONA GERIATRIC & DEMENTIA CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHY WALKER (ADMINISTRATOR)
(478) 949-2270
Entity
Organization
Contact information
Practice address
201 POPLAR ST, IDEAL, GA 31041-6264
(478) 949-2270
Mailing address
201 POPLAR ST, IDEAL, GA 31041-6264
(478) 949-2270
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
10941944
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141578A
—
GA
Enumeration date
11/18/2005
Last updated
10/14/2008
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