Organization
MOUNT EAGLE WINGS PERSONAL CARE HOME, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VENNA REESE (OWNER/ADMINISTRATOT)
(706) 284-9959
Entity
Organization
Contact information
Practice address
4027 PRESCOTT DR, MARTINEZ, GA 30907-4308
(706) 284-9959
Mailing address
4027 PRESCOTT DR, MARTINEZ, GA 30907-4308
(706) 284-9959
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
—
—
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
11/08/2009
Last updated
11/08/2009
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