Organization
PEACH STATE NURSING AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBIN LONG (PRESIDENT)
(478) 453-3369
Entity
Organization
Contact information
Practice address
140 W WASHINGTON ST, MILLEDGEVILLE, GA 31061-3434
(478) 453-3369
(478) 453-1131
Mailing address
PO BOX 326, 140 WEST WASHINGTON ST., MILLEDGEVILLE, GA 31059-0326
(478) 453-3369
(478) 453-1131
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
005-R-0003
GA
Other
Enumeration date
11/10/2006
Last updated
08/22/2020
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