Organization
ORCHID PERSONAL CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANIAS HASSELL (OWNER / CEO)
(706) 507-0142
Entity
Organization
Contact information
Practice address
7661 KAYNE BLVD, SUITE C, COLUMBUS, GA 31909-2545
(706) 507-0142
(706) 507-2374
Mailing address
7661 KAYNE BLVD, SUITE C, COLUMBUS, GA 31909-2545
(706) 507-0142
(706) 507-2374
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
109-01-167-1
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
223468425A
—
GA
Enumeration date
03/22/2010
Last updated
03/22/2010
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