Organization
GEORGIA DEPT OF HUMAN RESOURCES
Active
Other names
Allen Hall
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARVIN BAILEY (REGIONAL HOSPITAL ADMINISTRATOR)
(478) 445-4128
Entity
Organization
Contact information
Practice address
171 ALLEN RD, MILLEDGEVILLE, GA 31062-7525
(478) 445-4128
Mailing address
171 ALLEN RD, MILLEDGEVILLE, GA 31062-7525
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00142414A
—
GA
Enumeration date
08/16/2006
Last updated
08/22/2020
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