Organization
VISION PERSONAL CARE HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANDRIYEL MARIE BEN (OWNER/ADMINISTRATOR)
(504) 270-4439
Entity
Organization
Contact information
Practice address
960 CURRY PL, MACON, GA 31211-1804
(478) 750-4401
(478) 746-7774
Mailing address
PO BOX 518, MACON, GA 31202-0518
(478) 750-4401
(478) 746-7774
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
011-01-105-1
GA
Other
Enumeration date
01/15/2008
Last updated
11/28/2011
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