Organization
SOUTHERN ELDERLY HOME CARE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KISSEY KENSHAWN SHARPE (CERTIFIED NURSING ASSISTANT)
(404) 402-3759
Entity
Organization
Contact information
Practice address
2220 MCMILLAN DR, MACON, GA 31216-5854
(404) 402-3759
Mailing address
2220 MCMILLAN DR, MACON, GA 31216-5854
(404) 402-3759
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
GA
Other
Enumeration date
03/10/2015
Last updated
04/06/2015
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