Organization
MAJESTIC SUNZ LIFE CENTER
Active
Organization
MAJESTIC SUNZ LIFE CENTER
Active
Other names
Bolton Living Agency
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ZEPHANIAH DWAYNE BAKER (PRESIDENT)
(706) 587-3906
Entity
Organization
Contact information
Practice address
40 LANTANA WAY, NEWNAN, GA 30265-4171
(706) 569-1133
Mailing address
1091 BOLTON CT, COLUMBUS, GA 31906-2616
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
038-R-1778
GA
314000000X
Skilled Nursing Facility
038-R-1778
GA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
CLA001048
—
Other
Enumeration date
04/14/2013
Last updated
02/08/2017
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