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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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