Organization
MALIBU HEALTH CARE AGENCY, INC,
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE MARTHE PIERRE (ADMINISTRATOR/RN)
(770) 873-6303
Entity
Organization
Contact information
Practice address
24 HIGHWAY 213, COVINGTON, GA 30014-7460
(770) 873-6303
Mailing address
24 HIGHWAY 213, COVINGTON, GA 30014-7460
(770) 873-6303
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
107-R-0357
GA
253Z00000X
In Home Supportive Care Agency
107-R-0357
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107-R-0357
DEPARTMENT OF HUMAN RESOURCES
GA
Enumeration date
05/05/2009
Last updated
05/05/2009
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