Organization
MAISON HEALTH AND SUPPORTIVE LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAYLA LANE (CEO)
(706) 207-5860
Entity
Organization
Contact information
Practice address
603 N MAIN ST, MOULTRIE, GA 31768-3319
(866) 624-7660
Mailing address
136 SOUTHLAKE DR, MOULTRIE, GA 31768-7945
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
05/22/2025
Last updated
05/23/2025
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