Organization
PIKE MANOR INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTA COOK CEO/CFO; PT (CEO/CFO)
(770) 567-0020
Entity
Organization
Contact information
Practice address
10642 HIGHWAY 19 N, ZEBULON, GA 30295-3192
(770) 567-0200
(770) 567-0010
Mailing address
10642 HIGHWAY 19 N, ZEBULON, GA 30295-3192
(770) 567-0200
(770) 567-0010
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
114030011
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000946789A
—
GA
Enumeration date
10/23/2008
Last updated
06/26/2019
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