Organization
CARE WIND PLACE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY LYNETTE THOMPSON B.S (DIRECTOR)
(478) 390-1172
Entity
Organization
Contact information
Practice address
2895 JORDAN AVE, MACON, GA 31217-4919
(478) 390-1172
(478) 330-6692
Mailing address
2895 JORDAN AVE, MACON, GA 31217-4919
(478) 390-1172
(478) 330-6692
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
CLA 000754
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
583023880A
—
GA
Enumeration date
09/20/2012
Last updated
09/20/2012
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