Organization
QUENCIE'S MANOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH ANDREWS (ADMINISTATOR)
(478) 832-5479
Entity
Organization
Contact information
Practice address
2104 JEFFERSONVILLE RD, MACON, GA 31217-4517
(478) 832-5479
(478) 239-5148
Mailing address
2104 JEFFERSONVILLE RD, MACON, GA 31217-4517
(478) 832-5479
(478) 239-5148
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
PCH009157
GA
Other
Enumeration date
05/07/2017
Last updated
05/07/2017
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