Organization
SOUTHERN BREEZE PCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNETTE M HOLLEY (CEO)
(706) 799-0308
Entity
Organization
Contact information
Practice address
127 S BELAIR RD, MARTINEZ, GA 30907-9111
(706) 799-0308
(706) 504-4162
Mailing address
127 S BELAIR RD, MARTINEZ, GA 30907-9111
(706) 799-0308
(706) 504-4162
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003143758A
—
GA
Enumeration date
03/26/2018
Last updated
03/26/2018
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